A New Surgical Approach for Reconstruction of the Achilles Tendon

Background. The limited skin mobility on the posterior surface of the lower third of the leg, along with a small amount of subcutaneous fat and the close proximity of the Achilles tendon, predisposes this area to tissue defects following surgery. Numerous surgical approaches have been proposed; however, none of them completely address the problem of tissue defect elimination when correcting persistent equinus foot deformity. The aim of the study — to demonstrate a new surgical approach for Achilles tendon reconstruction. Surgical technique description. The surgical approach for Achilles tendon lengthening involved creating an arched incision and sequentially isolating the skin and fascial flaps. Achilles tendon shortening was corrected using Z-plasty. After that, the tendon was covered first with a fascial flap, and then the skin was partially sutured without tension. The remaining soft tissue defect was covered with a skin graft. Patients underwent 6 weeks of plaster immobilization, after which full weight-bearing on the operated leg and physical therapy was allowed. Conclusion. The described surgical approach is simple to perform and allows for the simultaneous replacement of tissue defects following the correction of equinus foot deformity.