Reconstruction of the Achilles tendon and overlying soft tissue using antero-lateral thigh free flap

Reconstruction of combined loss of the Achilles tendon and overlying soft t issue was performed using an antero-lateral thigh free flap in three patien ts. The cutaneous portion is used to cover the open wound, and a piece of f ascia lata is utilised to replace the missing segment of the Achilles tendo n. The skin defect ranged From 5 x 2.5 to 7 x 5 cm, and the tendon loss mea sured from 3.5 to 5.5 cm in length. All of the patients showed satisfactory functional results with a follow-up period from 3 to 9 months. The advanta ges of the procedure are that: it is a single-staged operation; it promotes rapid healing of the tendo Achilles since the tendon substitute is well va scularised; it is adaptable to a wide range of defect sizes and shapes; it can be performed in the supine position without the need for postural chang e; and it can restore good contour and causes minimal morbidity at the dono r site. (C) 2000 The British Association of Plastic Surgeons.