Reconstruction of soft tissue defects overlying the Achilles tendon using the super extended abductor hallucis muscle flap.
BACKGROUND
Soft tissue defects overlying the Achilles tendon often occur after traumatic ruptures of the Achilles tendon or because of pressure ulcers in patients suffering from circulatory problems. Ideally, reconstruction should be achieved in as few stages as possible. Currently, there are different methods used to treat these defects. Here, we examined whether reconstruction of this region could benefit from the super extended abductor hallucis muscle flap.


METHODS
In 12 cadaver feet, the vascular supply and mobilization radius of the abductor hallucis muscle were studied to clarify the possible clinical utilization of this flap. A technique for Achilles defect reconstruction using this flap, along with the functional and cosmetic results in six patients are presented.


RESULTS
Our anatomic findings agree with those available in the literature and the adaptation in pedicle preparation allowed an increase in rotation of the flap for successful coverage of defects overlying the Achilles tendon. Using the super extended abductor hallucis muscle flap, the functionality and the anatomic shape were successfully reconstructed. Six weeks after surgery all patients were fully mobile, unless they suffered from Achilles tendon ruptures then they were mobile after 12 weeks.


CONCLUSIONS
The super extended abductor hallucis muscle flap might represent an alternative to established methods because of ease of handling and a shorter anesthesia compared with a free flap procedure.
Michlits
Wolfgang
W
Department of Plastic and Reconstructive Surgery, Hospital of Barmherzige Brüder, Salzburg, Austria.
Gruber
Sabine
S
Windhofer
Christian
C
Macheiner
Peter
P
Walsh
Molly
M
Papp
Christoph
C
D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000293:injuries*; D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D003668:Pressure Ulcer / Q000000981:diagnostic imaging / Q000601:surgery; D012421:Rupture; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D018616:Ultrasonography, Doppler, Duplex