scholarly journals One-Stage Reconstruction for Re-rupture of Achilles Tendon with Soft Tissue Infection: Using an Anterolateral Thigh Flap Incorporating a Vascularized Muscle Flap and a Strip of Iliotibial Tract

2018 ◽  
Vol 10 (02) ◽  
pp. 105-108
Author(s):  
Ryosuke Sato ◽  
Naohito Hibino ◽  
Masahiro Yamano ◽  
Shinji Yoshioka ◽  
Tomoya Terai ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Soft Tissue Infection ◽  
Muscle Flap ◽  
Tissue Infection ◽  
Successful Outcome ◽  
Anterolateral Thigh Flap ◽  
Iliotibial Tract ◽  
One Stage ◽  
Anterolateral Thigh

AbstractReconstruction is challenging in a patient with loss of a segment of Achilles tendon and infection in the overlying soft tissue. Here the authors describe one-stage tendon reconstruction, using an anterolateral thigh free flap incorporating a vascularized muscle flap and a strip of iliotibial tract in a patient with re-rupture of an Achilles tendon and soft tissue infection. Postoperative immobilization of the affected ankle using an external fixator enabled us to observe the flap directly and reduce pressure on the flap. The patient had a successful outcome, with no difficulty in walking, running, or climbing stairs and no limitation of range of motion at the ankle joint postoperatively. This is a promising technique for reconstruction of the Achilles tendon and treatment of infection as a one-step procedure.

Achilles Tendon Region Defects: Delayed Composite Anterolateral Thigh Flap With Stripping of Fascia Lata: A Case Series

2020 ◽  
Vol 66 (12) ◽  
pp. 13-22
Author(s):  
Cesare Tiengo ◽  
Regina Sonda ◽  
Andrea Monticelli ◽  
Francesco Messana ◽  
Alberto Crema ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Short Form ◽  
Case Series ◽  
Fascia Lata ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Reconstruction ◽  
Medical Outcomes ◽  
Anterolateral Thigh ◽  
Tissue Reconstruction

Defects of the Achilles tendon that include the surrounding soft tissue represent a challenge due to complex functionality and biomechanics. PURPOSE: The purpose of this study was to evaluate the functional and physical functioning score outcomes of patients following microsurgical reconstruction of the yarrow region, using a combination of objective, subjective, and semi-subjective measurements. METHODS: Between 2007 and 2018, 15 patients underwent delayed Achilles tendon region reconstruction with different anterolateral thigh flap types. Seven (7) patients underwent tendon and soft tissue reconstruction with a chimeric anterolateral thigh flap (ALT) and rolled-up fascia lata, and 8 patients underwent soft tissue reconstruction and only tendon coverage with fascia lata. Follow-up assessments included maximal range of motion (MROM) (plantarflexion and dorsiflexion), the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale score, and the Medical Outcomes Study 36-item Short-Form Health Survey physical functioning subscore. RESULTS: A total of 15 patients (11 males and 4 females with a mean age of 39.86 years) were evaluated during a mean follow-up time of 23 months (SD = 7.12). The MROM for plantarflexion and dorsiflexion was 42.71 degrees (SD = 2.9) and 24.8 degrees (SD = 4.29), respectively, in patients who underwent composite ALT with a rolled-up fascia lata. The MROM for plantarflexion and dorsiflexion was 43 degrees (SD = 5.37) and 27.37 degrees (SD = 3.2), respectively, in patients who underwent fasciocutaneous ALT. The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score was 82 for the first group and 86.87 for the second, whereas the mean Medical Outcomes Study 36-item Short-Form Health Survey scores were 82.57 and 81.5, respectively, for the 2 groups. Statistical analysis showed no significant difference between the 2 groups. CONCLUSIONS: The results of this case series suggest that the single-stage composite reconstruction with a fasciocutaneous flap with or without a strip of fascia lata is a safe and reliable strategy for composite reconstruction of the Achilles tendon region. Additional studies to evaluate these outcomes and instruments to evaluate functioning are necessary.

scholarly journals Successful Outcome of Post Liposuction Extensive Necrotizing Soft Tissue Infection of Abdomen and Concomitant Jejunal Perforation—A Case Report

2019 ◽  
Vol 52 (02) ◽  
pp. 238-241
Author(s):  
Hardeep Singh ◽  
Rakesh Kumar Khazanchi ◽  
Sanjay Mahendru
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Bowel Perforation ◽  
Skin Grafting ◽  
Tissue Infection ◽  
Successful Outcome ◽  
Costal Margin ◽  
Necrotizing Soft Tissue Infection ◽  
Abdominal Skin

Abstract Introduction Liposuction is one of the common cosmetic surgery procedures performed. Although rare, the complications associated with it are necrotizing soft tissue infection and bowel perforation. We would like to share our experience of such a complication that was managed successfully. Case Report We were referred a 65-year-old male patient with signs and symptoms of intestinal obstruction who had undergone liposuction of abdomen 1 week before and now had discoloration of the abdominal skin. The discoloration was present from just below the costal margin and was extending up to bilateral inguinal regions. Laterally the discoloration extended up to the mid axillary line on both sides. Imaging studies showed dilated small bowel. During laparotomy, he underwent debridement of all discolored skin and repair of the single jejunal perforation. Postoperatively patient was first managed on intravenous fluids, nasogastric aspiration and total parenteral nutrition for 10 days. The wound was managed with silver dressings that led to healthy granulations. The patient was at high risk for anesthesia for skin grafting; hence, he was managed with allograft for 10 days. The patient then underwent skin grafting once he was fit. The graft took up well and he resumed regular activities. Conclusion This is unique as the patient had extensive necrotizing soft tissue infection of the abdominal skin after liposuction along with intestinal perforation and obstruction that was managed successfully due to aggressive surgical intervention, allograft, and good supportive care both in the intensive care unit and in ward.

Single Stage Reconstruction of Posterior Soft Tissue Ankle Defects with a Free Anterolateral Thigh Flap and Rolled Tensor Fascia Lata for Functional Tendo-Achilles Reconstruction - A Case Report and Review of the Literature

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Bagirathan S ◽  
◽  
Ibrahim N ◽  
Patel NG ◽  
◽  
...  
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Fascia Lata ◽  
Single Stage ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Reconstruction ◽  
Tensor Fascia Lata ◽  
Anterolateral Thigh ◽  
Tissue Reconstruction ◽  
Sural Artery

Soft tissue defects in the posterior ankle region with underlying Achilles tendon loss pose a reconstructive challenge to both Orthopaedic and Plastic surgeons. Such injuries can result in a severely debilitating sequelae for the patient, therefore reconstruction of the area must provide reliable function and durability with minimal complications and aesthetically pleasing results to enable normal foot wear. We describe the case of a twenty-seven year old male, who presented following a traumatic open rupture of the Achilles tendon and failed reverse sural artery flap. We performed a single stage composite soft tissue reconstruction with a free anterolateral thigh (ALT) flap and rolled vascularised Tensor Fascia Lata (TFL) for functional Achilles tendon reconstruction. The patient had no post-operative complications and was able to fully weight bear and dorsiflex his foot beyond ninety degrees at seven month follow-up. Whilst many options are available to reconstruct this area, we review the literature to illustrate the advantages of using this technique to achieve all of the above factors, and advocate for all foot and ankle surgeons to be aware of its use in their reconstructive repertoire.

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