Immediate free tissue transfer for coverage of Achilles tendon injury or reconstruction

The restoration of function and contour to the Achilles region is a complex problem. This is reflected in the variety of reconstructive options described in the literature. The aim however remains to normalise the range of movement at the ankle joint and restore the power of plantar flexion. Few techniques have demonstrated this.

Six patients underwent soft tissue reconstruction over the Achilles tendon with a free scapular flap. Two ruptured Achilles tendons were reconstructed with FHL transfers.

All six flaps remained viable and achieved stable coverage over the Achilles tendon. Five of the six required thinning for use of normal foot wear. Those that had FHL transfer normalised their range of movement.

It has previously been shown that FHL transfer provides optimum results in terms of functional outcome while here the scapular flap has fulfilled the requirement to restore the contour of this region.