[Primary repair of tissue defects of achilles tendon and skin by free grafting of anterolateral femoral skin flap and iliotibial tract].

ABSTRACT

OBJECTIVE: To observe the clinical outcome of primary repair of the tissue defects of the Achilles tendon and skin by thigh anterolateral free flap and free iliotibial tract. METHODS: From January 2000 to January 2005, the thigh anterolateral free flap and the iliotibial tract were used to primarily repair the defects of the Achilles tendon and skin in 11 patients (7 males and 4 females, aged 6-45 years). The defects of the skin and Achilles tendon were found in 6 patients, and the defects of the Achilles tendon and skin accompanied by the fracture of the calcaneus were found in 5 patients. The defect of the Achilles skin was 6 cm X 5 cm-14 cm X 8 cm in area. The defect of the Achilles tendon was 5-11 cm in length. The skin flap was 11 cm X 6 cm-17 cm X 11 cm in area. The iliotibial tract was 7-13 cm in length and 3-5 cm in width. The medial and lateral borders were sutured to from double layers for Achilles tendon reconstruction. The wound on the donor site could be sutured directly in 5 patients, and the others could be repaired with skin grafting. RESULTS: After operation, all the flaps survived and the wound healed by first intention. The follow-up of the 11 patients for 6 mouths-4 years (average, 30 months) revealed that according to Yin Qingshui's scale, the result was excellent in 6 patients, good in 4, and fair in 1. The excellent and good rate was 99%. The results showed a significant improvement in the "heel test" and the Thompson sign, and both were negative. No complications of ulceration on the heel and re-rupture of the Achilles tendon occurred. CONCLUSION: The primary repair of the tissue defects of the Achilles tendon and skin by free grafting of the anterolateral femoral skin flap and the iliotibial tract is an effective surgical method.