Reconstruction of Soft Tissue Defects Including the Achilles Tendon with Free Neurovascular Tensor Fascia Lata Flap and Fascia Lata: Case Report

1987 ◽  
Vol 21 (2) ◽  
pp. 213-218 ◽  
Author(s):  
Disa Lidman ◽  
Hans Nettelblad ◽  
Anders Berggren ◽  
Soma Rajan
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Achilles Tendon ◽  
Fascia Lata ◽  
Soft Tissue Defects ◽  
Tensor Fascia Lata ◽  
Tensor Fascia Lata Flap ◽  
Tissue Defects

scholarly journals Double-Layer Reconstruction of the Achilles’ Tendon Using a Modified Lindholm's Technique and Vascularized Fascia Lata

2017 ◽  
Vol 10 (01) ◽  
pp. 049-051
Author(s):  
Osman Kelahmetoglu ◽  
Mustafa Gules ◽  
Nuh Elmadag ◽  
Ethem Guneren ◽  
Selma Sonmez Ergun
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Fascia Lata ◽  
Soft Tissue Defects ◽  
Anterolateral Thigh ◽  
Wound Healing Problems ◽  
Alt Flap ◽  
Tissue Defects

AbstractLoss of the Achilles’ tendon with overlying soft tissue and skin defects remains a complex reconstructive challenge. Herein we present our experience using a free composite anterolateral thigh (ALT) flap with vascularized fascia lata and a modified Lindholm's technique to repair the Achilles’ tendon. A 37-year-old man suffered from tertiary Achilles’ tendon rupture. For reconstruction, the free composite ALT flap with vascularized fascia lata was used to wrap Achilles’ tendon. A modified Lindholm's technique was used to cover overlying soft tissue defects. The patient was followed up for 12 months. No wound healing problems were reported, and the patient was able to walk and return to his daily ambulating activities without any support after 5 months postoperatively. This technique may be useful to achieve satisfactory outcomes in patients with ruptured Achilles’ tendons following tertiary repair.

Predictors of Clinical Outcome after Reconstruction of Complex Soft Tissue Defects Involving the Achilles Tendon with the Composite Anterolateral Thigh Flap with Vascularized Fascia Lata

2018 ◽  
Vol 34 (08) ◽  
pp. 632-641 ◽  
Author(s):  
Zaher Jandali ◽  
Martin Lam ◽  
Benedikt Merwart ◽  
Bernd Möhring ◽  
Stephanie Geil ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Outcome ◽  
Achilles Tendon ◽  
Range Of Motion ◽  
Fascia Lata ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Mri Studies ◽  
Anterolateral Thigh ◽  
Tissue Defects

Background The composite anterolateral thigh flap with vascularized fascia lata (ALT-FL flap) for covering complex soft tissue defects involving the Achilles tendon has shown promising results. The age and body mass index (BMI) are important predictors of clinical outcome after surgical treatment of Achilles tendon ruptures. In this study, we investigate whether these also influence the outcome of patients after Achilles tendon reconstruction using the ALT-FL flap. Methods Twenty patients (mean age: 55.9 ± 8.7 years) with complex tissue defects involving the Achilles tendon underwent reconstruction with the ALT-FL flap. Both the Achilles tendon Total Rupture Score (ATRS) and the American Orthopaedic Foot and Ankle Society (AOFAS) score were assessed preoperatively and 12 months postoperatively. In addition, postoperative magnetic resonance imaging (MRI) studies and measurements of the ankle range of motion were performed and results compared with existing literature. Results All flaps survived and MRI studies confirmed complete anatomical integration of the fascia lata as “neotendon” at the recipient site. In our patient cohort, the age did not correlate with the outcome measurements, whereas the BMI showed significant negative correlation with the postoperative ATRS (p < 0.001) and AOFAS scores (p < 0.05). The ATRS and AOFAS scores of all patients improved significantly (p < 0.001). However, obese patients with a BMI of more than 30 kg/m2 achieved significant lower ATRS (p < 0.001) and AOFAS scores (p < 0.01), as well as patients with peripheral artery disease (PAD) (p < 0.05). The mean ankle range of motion after ALT-FL flap reconstruction remained statistical insignificant compared with previous avascular or vascularized tendon repairs of the Achilles tendon. Conclusion The ALT-FL flap enables reconstruction of complex tissue defects involving the Achilles tendon with good functional results. However, the presence of an increased BMI or PAD, but not necessarily the age, proves to be a predictor of poor clinical outcome and therefore should be subject to scrutiny during patient selection.

The Bilobed Racquet Flap or Extended Seagull Flap for Thumb Reconstruction: A Case Report

2018 ◽  
Vol 23 (01) ◽  
pp. 128-131
Author(s):  
José Couceiro ◽  
Mariangeles De la Red-Gallego ◽  
Luis Yeste ◽  
Higinio Ayala ◽  
Manuel Sanchez-Crespo ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Thumb Reconstruction ◽  
Degloving Injury ◽  
Dorsal Metacarpal Artery ◽  
The Subject ◽  
Tissue Defects

The treatment of extensive soft tissue defects in the thumb with dorsal metacarpal artery flaps has been previously reported in the literature. Island flaps from the dorsum of the index and long fingers have been the subject of many reports and studies. However, when the defect involves the whole thumb, a 360° circumferential defect, standard first or second dorsal metacarpal artery flaps are usually insufficient. There are fewer reports on the use of bilobed flaps for this application and we have found no reports on the use of bilobed racquet flaps or extended seagull flaps as treatment for this condition. We report the salvage of a thumb degloving injury with use of a bilobed racquet flap.

The Treatment of Complex Motorcycle Spoke Injuries in Children

2018 ◽  
Vol 108 (5) ◽  
pp. 409-418
Author(s):  
Jiasharete Jielile ◽  
Pengfei Li ◽  
Wulan Bahetiya ◽  
Aynaz Badelhan ◽  
Bayixiati Qianman ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Effective Treatment ◽  
Distraction Osteogenesis ◽  
External Fixator ◽  
Soft Tissue Defects ◽  
Third Stage ◽  
Length Width ◽  
Age Range ◽  
Tissue Defects

Motorcycle spoke injuries involving the soft tissue, Achilles tendon, and calcaneal defects are rare in children. Currently, calcaneal defects are very challenging to treat. Multiple methods have been used in clinical practice; however, an effective treatment has yet to be established, especially when Achilles tendon and soft-tissue defects are also present. It is important to address this condition, because the calcaneus plays a key role in standing and gait. Unsatisfactory treatment of calcaneal defects may significantly decrease patients' quality of life (eg, by limiting mobility). In this article, we report the effective treatment of calcaneal defects in four children using distraction osteogenesis with an external fixator framework designed by the authors. From May 2014 to May 2015, four children (age range, 6–11 years) with defects of the Achilles tendon, soft tissue, and calcaneus resulting from a motorcycle accident were treated at our hospital. The Achilles tendon and soft-tissue defects were treated with second-stage reconstruction. In the third-stage surgery, osteotomy of the residual calcaneus was performed. A customized external fixator was used to lengthen the calcaneus at a rate of 1.5 mm/day in the posterior direction and reposition it by 40° in the inferior direction. In all four children, the calcaneus was lengthened by 5 cm. Distraction osteogenesis through external fixation is effective for restoring the length, width, and height of the calcaneus in children.

Combined Achilles Tendon and Soft Tissue Defects

2015 ◽  
Vol 74 (1) ◽  
pp. 121-125 ◽  
Author(s):  
Matthew L. Iorio ◽  
Kevin D. Han ◽  
Karen K. Evans ◽  
Christopher E. Attinger
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Soft Tissue Defects ◽  
Tissue Defects

scholarly journals Brachioradialis Flap With Vascularized Lateral Ulnar Collateral Ligament Reconstruction: A Case Report

Hand ◽  
2019 ◽  
Vol 15 (2) ◽  
pp. NP37-NP41
Author(s):  
Nicholas A. Trasolini ◽  
Jerry Chidester ◽  
Alidad Ghiassi ◽  
Milan Stevanovic
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Ulnar Collateral Ligament ◽  
Soft Tissue Defect ◽  
Soft Tissue Defects ◽  
Collateral Ligament ◽  
Lateral Ulnar Collateral Ligament ◽  
Lateral Elbow ◽  
Rotational Flap ◽  
Tissue Defects

Background: Soft tissue defects about the elbow with concurrent ligamentous instability can be challenging to treat. Methods: We present a case report of a lateral elbow wound that resulted in lateral ulnar collateral ligament deficiency and posterolateral elbow instability. Results: We describe our technique of a modified brachioradialis rotational flap, in which the muscle is rotated to cover the soft tissue defect, while the vascularized brachioradialis tendon is used to simultaneously reconstruct the lateral ulnar collateral ligament. This procedure successfully restored posterolateral elbow stability at the time of wound coverage. Conclusion: Elbow soft tissue defects with associated ligamentous injuries can be treated using a modification of the brachioradialis rotational flap.

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