We report a method of Achilles tendon reconstruction using a free quadriceps bone-tendon graft. The patient had a prior repair of a re-ruptured Achilles tendon, following which he developed massive necrosis of his skin and Achilles tendon leaving a 10 cm defect. First stage reconstruction consisted of soft tissue coverage of the skin defect with a sural fasciocutaneous flap. Reconstruction of the Achilles tendon followed, with the patellar bone block fixed to the calcaneus and the quadriceps tendon sutured proximally.
Get full access to this article
View all access options for this article.
References
1.
AbrahamE.PankovichA. M.: Neglected rupture of the Achilles tendon: Treatment by a V-Y tendinous flap. J. Bone Joint Surg., 57A: 253–255, 1975.
2.
BabuV.ChittaranjanS.AbrahamG.KorulaR. J.: Single-stage reconstruction of soft-tissue defects including Achilles tendon using the dorsalis pedis arterialized flap along with the extensor digitorum brevis as bridge graft. Plast. Reconstr. Surg., 93(5): 1090–1094, 1994.
3.
FulkersonJ. PLangelandR.: An alternative cruciate reconstruction graft: The central quadriceps tendon. Arthroscopy, 11(2): 252–254, 1995.
4.
HowardC. B.WinstonI.BellW.JenkinsD. R. H.: Late repair of the calcaneal tendon with carbon fibre. J. Bone Joint Surg., 66B: 206–208, 1984.
5.
InoueT.TanakaI.ImaiK.HatokoM.: Reconstruction of Achilles tendon using vascularised fascia lata with free lateral thigh flap. Br. J Plast Surg., 43: 728–731, 1990.
6.
LynnT. A.: Repair of the torn Achilles tendon, using the plantaris tendon as a reinforcing membrane. J Bone Joint Surg., 48A: 268–272, 1966.
7.
MannR. A.HolmesG. B.SealeK. S.CollinsD. N.: Chronic rupture of the Achilles tendon: A new technique of repair. J Bone Joint Surg., 73A: 214–219, 1991.
8.
OzakiJ.FujikJ.SugimotoK.TamaiS.MasuharaK.: reconstruction of neglected Achilles tendon rupture with Marlex mesh. Clin. Orthop., 238: 204–208, 1989.
9.
PlattH.: Observations of some tendon ruptures. Br. Med. J., 1: 811, 1931.
10.
TeufferA. P.: Traumatic rupture of the Achilles tendon - Reconstruction by transplant and graft of the lateral peroneus brevis. Orthop. Clin. North Am., 5: 89–93, 1974.
11.
WapnerK. L.PavlockG. S.HechtP. J.NaselliF.WaltherR.: Repair of chronic Achilles tendon rupture with flexor hallucis tendon transfer. Foot Ankle., 14(8): 443–449, 1993.
12.
WarisT. H.KaarelaO. I.RaatikainenT. K.TeerikangasH. E.HeikkinenE. S.: Microvascular flaps from the lateral arm and radial forearm for the repair of defects of the Achilles tendon. Scand. J Plast. Reconst. Hand Surg., 25: 87–89, 1991.
13.
WeiF. C.ChenH. C.ChuangC. C.NoordhoffM. S.: Reconstruction of Achilles tendon and calcaneus defects with skin-aponeurosis-bone composite free tissue from the groin region. Plast. Reconstr. Surg., 81(4): 579–587, 1988.