Related Experiment Video
Updated: Oct 25, 2025
Engineered Vascularized Muscle Flap
Published on: January 11, 2016
Simultaneous Reconstruction of Achilles Tendon and Soft-Tissue Defects with a Composite Anterolateral Thigh Free Flap
Patrick Duhamel1, Sébastien Fossat1, Michel Brachet1
1Plastic and Maxillofacial Surgery Service (P.D., S.F., M.B., and E.B.) and Orthopaedic Surgery and Trauma Service (L.M. and S.R.), HIA Percy, 101 Avenue Henri Barbusse, BP 406-92141 Clamart, France. E-mail address for P. Duhamel: patrick.duhamel1@club-internet.fr. E-mail address for S. Fossat: sebastien_fossat@yahoo.fr. E-mail address for M. Brachet: brachet@bbox.fr. E-mail address for L. Mathieu: laurent_tom2@yahoo.fr. E-mail address for S. Rigal: s.rig@libertysurf.fr. E-mail address for E. Bey: bey.eric@yahoo.fr.
Introduction:
Reconstruction to treat segmental loss of the Achilles tendon combined with soft-tissue defects can be challenging, particularly after the recurrent ruptures that may occur during intense physical activity.
Step 1 Preoperative Planning:
Design flap and use Doppler ultrasound for perforator mapping.
Step 2 Debride Wound And Prepare Recipient Vessels:
Use a two-team approach, one for the affected side and one for the unaffected side.
Step 3 Harvest The Composite Alt Flap:
Take care to include one or two perforator vessels in the flap and to avoid vessel damage throughout the dissection.
Step 4 Perform Vascular Anastomosis:
Use the posterior tibial vessel as the recipient site for the microvascular anastomosis.
Step 5 Reconstruct The Achilles Tendon:
Suture the rolled up vascularized fascia lata sheet; then check for tension.
Step 6 Postoperative Care:
Gradual, protected weight-bearing begins at twelve weeks.
Results & Preop/Postop Images:
For recurrent tendon rupture, this single-step reconstruction saves both time and expense and it provides a functional tendon reconstruction (enabling normal daily activities) with limited donor-site morbidity and an acceptable cosmetic result without the need for a later debulking procedure.
What To Watch For:
IndicationsContraindicationsPitfalls & Challenges.
