Management of chronic achilles tendon infection with musculotendinous gracilis interposition free-flap coverage.
Management of infected Achilles tendon repair poses a significant reconstructive problem. Thorough debridement is most important and resection of non-viable tendon substance is required. Reconstruction of such tendon defects requires vascularized soft-tissue coverage that is stable and that offers the possibility of functional restoration. Gracilis free-tissue transfer is an effective means of providing stable, durable, well-vascularized, soft-tissue coverage in an infected Achilles tendon repair. The microsurgical anastomoses are technically straightforward. Cybex II dynomometer measurements, performed 6 months following free-tissue transplantation, revealed strength (torque) and power, at an angular velocity of 45 degrees per second, of: 59 percent and 52 percent, respectively, compared to the uninjured side. Endurance was assessed at an angular velocity of 120 degrees per second over a 15-second test interval, and was noted to be 81 percent, compared to the normal ankle. Excellent functional results and acceptable soft-tissue contour can be expected with this technique.
Feibel
R J
RJ
Department of Surgery, University of Ottawa.
Jackson
R L
RL
Lineaweaver
W C
WC
Buncke
H J
HJ
D000125:Achilles Tendon / Q000293:injuries / Q000601:surgery*; D000328:Adult; D002908:Chronic Disease; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D012421:Rupture; D013524:Surgical Flaps / Q000379:methods*; D013530:Surgical Wound Infection / Q000601:surgery*