title: [Dynamic reconstruction of Achilles tendon by free composite perforator flap with functional assessment].
abstract: Achilles tendon are common in patients after immobilization, therefore the reconstruction of a ruptured Achilles tendon with defects remains a surgical challenge. The ideal characteristics are a thin layer of skin, a strong tendon component, combined with a reliable blood supply and minimal morbidity at the donor site. We present a reconstructive technique using a composite anterolateral thigh perforator free flap, meeting these criteria, for the treatment of rupture of Achilles tendon with cutaneous and tendon defect.
  
  
  METHODS
  A 34-year-old patient presenting a third rupture of his left Achilles tendon with 4cm composite defect was reconstructed with a contralateral anterolateral thigh perforator flap with part of the fasciae latae. The latter was raised by dissecting one intramuscular perforating artery from a descending branch of the lateral circumflex femoral artery. The postoperative observation period was one year. The functional outcome was determined by clinical scores (IKDC, OAK and Lysholm-Tegner).
  
  
  RESULTS
  The healing time was 21 days. At six months, the aesthetic and functional result was satisfactory without delayed healing or secondary rupture. The aesthetic discomfort at the donor site was considered negligible by the patient. At one year, there is a continuing stability with no recurrence. The functional result was considered good with a clinical score of 75/100.
  
  
  CONCLUSIONS
  Therefore, this method seems to be a good option for complex reconstruction of Achilles meeting the requirements of reconstruction with good stability at a distance.
authors: Service de chirurgie plastique, reconstructrice et esthétique, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France; Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
authors: G
authors: G
authors: Michel
authors: Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
authors: C
authors: C
authors: Ho Quoc
authors: Service de chirurgie plastique, reconstructrice et esthétique, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
authors: N
authors: N
authors: Assaf
authors: Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
authors: E
authors: E
authors: Delay
authors: Service de chirurgie plastique, reconstructrice et esthétique, hôpital Nord, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France. Electronic address: raphaelsinna@gmail.com.
authors: R
authors: R
authors: Sinna
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D006801:Humans; D008297:Male; D061525:Perforator Flap; D012421:Rupture / Q000601:surgery
keywords: Achilles tendon; Fascia lata; Free flap; Lambeau libre; Lambeau perforant cuisse; Perforator flaps; Perte de substance tendineuse; Reconstructive surgical procedures; Tendon defect; Tendon d’Achille; Thigh