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Reconstruction of the severe Achilles tendon and soft-tissue loss with the bi-pedicled conjoined flap and vascularized fasciae latae: A consecutive case series of 15 patients.
Huang, Yu; Tang, Lin; Liu, Anming; Zhou, Xin; Huang, Shuqing.
Afiliación
  • Huang Y; Department of Orthopedic Hand Surgery, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Chunhui Avenue, Longma Tan District, Luzhou 646000, China.
  • Tang L; Department of Orthopedic, Southwest Hospital of Army Medical University, Jianxindong Road, Jiang Bei District, Chongqing 400037, China.
  • Liu A; Department of Orthopedic Hand Surgery, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Chunhui Avenue, Longma Tan District, Luzhou 646000, China. Electronic address: Amliu1980@163.com.
  • Zhou X; Department of Plastic and Cosmetic Surgery, Xinqiao Hospital of Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing 400037, China.
  • Huang S; Department of Plastic and Cosmetic Surgery, Xinqiao Hospital of Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing 400037, China.
Injury ; 54(4): 1210-1215, 2023 Apr.
Article en En | MEDLINE | ID: mdl-36849302
ABSTRACT

BACKGROUND:

Historically, the segmental loss of the Achilles tendon with overlying soft-tissue defects had been frequently reconstructed with the composite anterolateral thigh (ALTP) flap, including the iliotibial tract or fasciae latae. This study aimed to present our modified combination using the bi-pedicled conjoined flap with vascularized fasciae latae, for the approximately total reconstruction of the Achilles tendon and extensive soft tissue.

METHODS:

From May 2015 to March 2018, 15 patients (9 male and 6 female) with a mean age of 36 years (ranged, 18-52 years) underwent microvascular Achilles tendon reconstruction. Harvested on the abdomen and groin, the conjoined flap was chimeric with the vascularized fasciae latae. Primary donor-site closure was accomplished in all patients. A standard assessment of the functional and esthetical outcomes was completed.

RESULTS:

Mean follow-up time was 42 months (ranged, 32-48 months). The average dimension of the conjoined flap was 25 × 14 cm (ranged, 18 × 10-35 × 18 cm), and the average size of the folded fasciae latae was 15 × 6 cm (ranged, 12 × 5-25 × 8 cm). At the last follow-up, the Thompson test was negative in all patients. The mean American Orthopedic Foot and Ankle Society (AOFAS) score was 91.0. The mean Achilles tendon total rupture score (ATRS) was 18.5. The mean Vancouver Scar Scale (VSS) score was 3.0.

CONCLUSIONS:

The composite bi-pedicled flap including vascularized fasciae latae provides an alternative approach with great functional and esthetic outcomes, in selected patients who suffered severe Achilles tendon and skin defects. The one-stage procedure facilitates better rehabilitation postoperatively.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Tendón Calcáneo / Traumatismos de los Tendones / Traumatismos de los Tejidos Blandos / Procedimientos de Cirugía Plástica Límite: Adult / Female / Humans / Male Idioma: En Revista: Injury Año: 2023 Tipo del documento: Article País de afiliación: China

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Tendón Calcáneo / Traumatismos de los Tendones / Traumatismos de los Tejidos Blandos / Procedimientos de Cirugía Plástica Límite: Adult / Female / Humans / Male Idioma: En Revista: Injury Año: 2023 Tipo del documento: Article País de afiliación: China