Achilles Tendon Reconstruction after Sural Fasciocutaneous Flap Using Achilles Tendon Allograft with Attached Calcaneal Bone Block

Open Achilles Tendon Defects: A 12-year Study on the Injury Mechanisms, Reconstructions, and Late Complications

“…The bone grafts were sourced from the iliac bone, 6 olecranon fragment, 12 radia bone block, 18 patellar bone block, 2 and allograft calcaneus block. 39 In this study, we did not use bone graft for the reconstruction of posterior calcaneus defects. It seemed unnecessary.…”

“…Later, this technique was used for the open Achilles tendon defect. 25,32,39,40 The rejection of the allograft and postoperative infection could be a problem. We used this technique in the following three cases: two with freeze-dried tendons and one with deep hypothermia-stored tendons.…”

What Is the Treatment “Algorithm” for Infection After Achilles Tendon Repair/Reconstruction?

“…Although the literature generally agrees that the most important aspect of treatment revolves around an extensive debridement of the infected/necrotic tissue and antibiotic coverage, each author has his or her own opinion on how tendon and soft tissue defects should be addressed. These opinions range from extensive debridement with functional rehabilitation alone, 2,8 to local tendon/tissue transfer, 1,6,10,16,17,21 to free flaps. 7,9,11,13-15 Additional variations of treatment include single versus staged procedures, 3,12 the utilization of cement spacers, 3,12 tissue expanders.…”

“…14 Bone biopsies taken for microbiologic and histopathologic analysis are the gold standard for a definitive diagnosis of osteomyelitis. [8][9][10] A specimen can be obtained either transcutaneously through uninfected skin or as part of an operative procedure following debridement. Bone biopsies play both a crucial diagnostic and interventional role in the management of diabetic foot infection.…”

Flexor Hallucis Longus Muscle and Tendon Transfer for the Treatment of Achilles Tendon Wounds

“…No consensus exists for the treatment of Achilles tendon wounds that are not amenable to primary closure; however, fasciocutaneous rotational flaps and free flap coverage are often advocated. 5,8,9,14,16 While these procedures are generally met with success, they have multiple drawbacks including donor site morbidity, added bulk to the heel that can limit shoe wear, high expense, requirement for expertise not frequently available in the community setting, and need for close postoperative monitoring. Furthermore, up to 8% of patients can experience flap failure in this area, a scenario that may require transtibial amputation.…”