title: Medial Achilles tendon island flap--a novel technique to treat reruptures and neglected ruptures of the Achilles tendon.
abstract: OBJECTIVE
  There is a strong consensus for surgical treatment of reruptures and neglected ruptures of the Achilles tendon. A number of different surgical techniques have been described and several of these methods include extensive surgical exposure to the calf and technically demanding tendon transfers. The overall risk of complications is high and in particular the risk for wound healing problems, which are triggered by an increased tension in the skin when inserting a bulky graft to cover the rupture. In order to reduce the risk for wound healing problems a new, less complicated surgical technique was developed, as described in this study.
  
  
  METHODS
  Nine consecutive patients (including six chronic ruptures and three reruptures) with complicating co-morbidities and with a tendon defect between three and eight centimetres were operated upon using the described novel technique. Patient-reported functional outcome was reported after two to eight years.
  
  
  RESULTS
  All tendon defects were successfully repaired. Neither early nor late surgical complications occurred. High patient satisfaction was reported for all patients.
  
  
  CONCLUSIONS
  The new surgical technique with a medial Achilles tendon island flap seems to be safe and results in a good patient reported outcome.
authors.affiliation: Department of Clinical Science and Education, Section of Orthopaedics, Karolinska Institutet, Södersjukhuset, Sweden. lasse.lapidus@sodersjukhuset.se
authors.forename: Lasse J
authors.initials: LJ
authors.lastname: Lapidus
authors.forename: Bill Adams
authors.initials: BA
authors.lastname: Ray
authors.forename: Per
authors.initials: P
authors.lastname: Hamberg
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000502:physiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012421:Rupture / Q000601:surgery; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology