Free tissue coverage of wound complications following Achilles tendon rupture surgery.

The purpose of this study was to examine the long term functional results following free tissue coverage in 4 patients who developed wound complications after surgical treatment of partial or total Achilles tendon rupture. Between 1987 and 1993, 3 radial forearm flaps and 1 lateral arm flap were used. Two Achilles tendons were reinforced, 1 with palmaris longus tendon, and 1 with extensor carpi radialis and palmaris longus tendons. The patients were seen during followup an average of 3.1 years after the reconstruction. All patients were able to return to their preoperative level of activity within a year, and the aesthetic outcome was good in all cases. Isometric and isokinetic calf muscle performance was evaluated with a Lido Multi Joint II dynamometer, which showed the mean of isometric test values in 3 patients to be greater than 90% of that of the normal unaffected side, and probably abnormal (80%) in 1 patient. The mean isometric values obtained in 3 ankle positions, 20° plantar flexion, neutral, and 10° dorsiflexion, were 114%, 104%, and 94%, respectively. Isokinetic peak torque values were normal in 3 patients at a velocity of 30° per second, and in 2 at 90° per second. The mean peak torque value was 90% of normal at both angle velocities. The cross sectional area of the calf muscle was greater than 90% of the normal unaffected side. Ultrasonography indicated that the diameters of 2 reinforced tendons were larger than those on the control sides. Posterior peritendinous fibrosis was found in the upper corner of the scar in 2 patients.