MANAGEMENT OF CHRONIC ACHILLES-TENDON INFECTION WITH MUSCULOTENDINOUS-GRACILIS INTERPOSITION FREE-FLAP COVERAGE

Management of infected Achilles tendon repair poses a significant reco nstructive problem. Thorough debridement is most important and resecti on of non-viable tendon substance is required. Reconstruction of such tendon defects requires vascularized soft-tissue coverage that is stab le and that offers the possibility of functional restoration. Gracilis free-tissue transfer is an effective means of providing stable, durab le, well-vascularized, soft-tissue coverage in an infected Achilles te ndon repair. The microsurgical anastomoses are technically straightfor ward. Cybex II dynomometer measurements, performed 6 months following free-tissue transplantation, revealed strength (torque) and power, at an angular velocity of 45 degrees per second, of: 59 percent and 52 pe rcent, respectively, compared to the uninjured side. Endurance was ass essed at an angular velocity of 120 degrees per second over a 15-secon d test interval, and was noted to be 81 percent, compared to the norma l ankle. Excellent functional results and acceptable soft-tissue conto ur can be expected with this technique.