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49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

13.09. - 15.09.2018, Bochum

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Orthopädie: Mikrochirurgische Rekonstruktion bei Achillessehnendefekten nach primärer orthopädischer Achillessehnen Plastik

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  • presenting/speaker Denis Ehrl - Ludwig-Maximilians-Universität München
  • Riccardo Giunta - Campus Innenstadt LMU Klinikum
  • Paul Heidekrüger - Universitätsklinikum Regensburg
  • Milomir Ninkovic - Klinikum Bogenhausen
  • P. Niclas Broer - Klinikum Bogenhausen
  • Andreas Schmidt - Kinderchirurgische Gemeinschaftspraxis Dr. med. Andreas Schmidt Dr. med. Claudia Herzog Hailegiorgis Zerai
  • Franz Liska - Klinikum rechts der Isar, Technische Universität München

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 49. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 23. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Bochum, 13.-15.09.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc187

doi: 10.3205/18dgpraec187, urn:nbn:de:0183-18dgpraec1873

Published: September 20, 2018

© 2018 Ehrl et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background: Following trauma of the Achilles tendon, complications -even after successful primary repair- such as re-rupture or infections are not infrequent due to the often marginal perfusion, anatomical location as well as functional requirements of the tendon. This study aimed to evaluate the outcomes of the free composite fascio-cutaneous anterolateral thigh (ALT) flap including vastus lateralis fascia for reconstruction of complex soft-tissue and Achilles tendon defects.

Methods: Within an 8-year period, 35 patients having undergone microvascular Achilles tendon reconstruction fulfilled inclusion criteria for this study. 70.3% (26) of these patients returned for follow-up examination and 26.9% (7) of patients underwent additional pressure measurement. The data were screened for patients" demographics, intra- and perioperative details, flap survival, surgical complications and outcomes of the follow-up examinations.

Results: Mean follow-up time was 39.3 months. The Thomson-test was positive in all patients. The NRS at the Achilles tendon was low and showed significant differences between rest and at activity (p < 0.05). The assessment of the VSS showed very good results. The measurement of the peak pressure, power while walking, size of foot contact and range of motion did not show significant differences between the operated and non-operated sides (p > 0.05).

Conclusion: In patients having suffered from complex Achilles tendon injury requiring free flap coverage, the composite ALT flap including vastus lateralis fascia provides a reliable and safe method with very good functional and aesthetic outcomes. It should be considered one of the first reconstructive options.