Various reconstructive options for the coverage of exposed tendoachilles tendon

Background: Achilles tendon is the most commonly ruptured tendon in the human body. Injury may occur due to accidental slippage of foot, accidental cut by sharp household, machinery tools, spontaneous rupture, road traffic accidents, etc., In rural India, another common mechanism of injury is slippage of foot in Indian type lavatory pans. Skin over tendoachilles is thin and pliable to facilitate smooth tendon excursion and aid in dorsi and plantar flexion of foot. However, soft tissue defects of this region are difficult to reconstruct because of paucity of skin, soft tissue, and poor vascularity. Aim: To evaluate the use of various fasciocutaneous flaps for tendoachilles defects. Patients and Methods: This retrospective study was conducted in the Department of Plastic and Reconstructive Surgery, Siddartha medical college, Andhra Pradesh, from May 2023 to May 2025 for a period of two years. Fifteen patients with soft tissue defects over tendoachilles were studied. The etiology, size of defect, and the various reconstructive flaps used and postoperative course were evaluated. Results: Out of 15 patients, 13 were male and two were female. The age group ranged from three to 60 years. Most of the defects are due to road traffic accidents. Reverse sural artery flap, lateral calcaneal artery flap, lateral supramalleolar flap, keystone flap, and peroneus brevis muscle flap were used to cover these defects. Conclusion: Fasciocutaneous flaps play a major role in reconstruction of defects over the tendoachilles region. Long-term follow-up with physiotherapy is essential to achieve good function of tendoachilles.