Lateral femoral composite tissue transfer in reconstruction of defects of Achilles tendon and surrounding soft tissue
10.3760/cma.j.cn441206-20241124-00259
- VernacularTitle:股外侧复合组织移植修复跟腱及周围软组织缺损
- Author:
Chuangguo DAI
1
;
Xinhong WANG
1
;
Xiaoju ZHENG
1
;
Haijun LI
1
;
Zhong ZHANG
1
;
Baoshan WANG
1
Author Information
1. 西安凤城医院手足显微外科，西安 710016
- Publication Type:Journal Article
- Keywords:
Achilles tendon defect;
Surgical flap;
Tissue transfer;
Reconstruction;
Microsurgical technique
- From:
Chinese Journal of Microsurgery
2025;48(1):20-24
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of the transfer of lateral femoral fascia or combined with anteriolateral thigh flap (ALTF) on treatment of defects of Achilles tendon and surrounding soft tissue.Methods:From May 2004 to December 2021, 15 patients with Achilles tendons defects were treated with the transfer of either lateral femoral fascia or combined with ALTF in the Department of Hand and Foot Microsurgery, Xi'an Fengcheng Hospital. Two of the patients had postoperative infection after the primary treatment for Achilles tendon rupture and 13 patients had Achilles tendon defect together with various grade of defects of surrounding soft tissues. According to the size of wound, ALTFs and lateral superior knee flaps were used for the reconstructions. Various complex tissue flaps were used in reconstructive surgery: ALTF in 10 patients, the lateral thigh muscular flap in 3 patients and the lateral knee artery flap in 5 patients. The length of Achilles tendon defect was 3.0-8.0 cm and the length of fascia was 4.0-9.0 cm. The sizes of the flaps were 4.0 cm×3.0 cm-30.0 cm×18.0 cm. After the fascia and the flaps were harvested, the fascia was rolled up or wrapped up around the muscle with the knee at 30° flexion and the ankle at 30° flexion. Then end-to-end or end-to-side blood vessel anastomoses were carried out. The ALTFs were used to cover the wounds.Results:All the 15 flaps survived. After 2 to 5 years of follow-up, the heel lift test was found negative, without re-broken of Achilles tendon. All patients were in normal walking gait, except 2 patients who had mild lameness. According to the Amer-Lindholm scoring criteria, the results were excellent in 13 patients and good in 2 patients.Conclusion:Lateral thigh composite tissue transfer is an effective method to reconstruct Achilles tendon and the defects of its surrounding tissues.
