V-Y gastrocnemius muscle slide with turnover fascial flap for compound Achilles defects: a simple solution.
BACKGROUND
Compound defects of the Achilles region pose a reconstructive challenge. Poor vascularity of the Achilles region predisposes to complications. Repair of the tendon with simultaneous soft-tissue cover gives the patient the best chance to recover.


METHODS
Gastrocnemius musculotendinous V-Y slide for Achilles tendon defect with non-axial turnover fascial flaps based on the proximal end of the defect with a split-skin graft on the fascial flap was used in two patients. The vascular bases of such flaps and the technical details has been discussed.


RESULTS
The functional and aesthetic results were highly satisfactory with minimal donor-site morbidity. The flap was thin enough to fit the contour of the Achilles region. The fascial flap with skin graft was durable and withstood footwear well. The flap also allowed tendon gliding beneath it, with near-complete movements at the ankle joint.


CONCLUSIONS
Large flaps can sufficiently be raised with a wide base to cover small- to medium-sized defects. It is a good, rapid and cost-effective solution for a difficult clinical problem.
Department of Plastic Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India. plasticandeye@gmail.com
N K
NK
Agrawal
V
V
Bhattacharya
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis / Q000601:surgery*; D000843:Ankle Joint / Q000502:physiology; D005205:Fascia / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D013524:Surgical Flaps; D015599:Trauma Severity Indices; D055815:Young Adult