Achilles tendon reconstruction with a half-width achilles graft and wrap-around fascial flap

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A 70-year-old man complained imbalance while walking, inability to perform ankle flexion, and could not stand on tip-toe 3 months after injury. The ankle looked swollen with loss of Achilles contour and obvious gait disturbance. Magnetic resonance imaging shows a 5-cm Achilles tendon gap. Subsequently, surgery was performed to solve the neglected Achilles tendon rupture. Patient was put under general anesthesia with a regional block. Using a non-tourniquet technique, a reconstructive procedure was performed using a half-width autolo-gous Achilles tendon graft, which was attached to the calcaneal prominence with wire in a double strand Bunnell fashion. As for the proximal stump, double core Bunnell/modified Kes-sler suturing was carried out to suture the graft to Achilles stump. To increase the vascular-ization, an ipsilateral gastrocnemius fascial flap with a distally based-pedicle was harvested to wrap around the tendon graft. At a 6-month follow-up, the patient was able to stand on tip-toe and had also regained a normal gait.

Original languageEnglish
Pages (from-to)267-271
Number of pages5
JournalArchives of Plastic Surgery
Issue number3
Publication statusPublished - 1 May 2019


  • Achilles tendon
  • Gait
  • Reconstructive surgical procedures
  • Tourniquets


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