One-staged reconstruction of Achilles tendon and overlying skin defects with suppuration: using peroneus brevis tendon transfer and reversed sural neurofasciocutaneous flap.

The combined loss of the Achilles tendon and the overlying soft tissue with suppuration has been treated with many single- or multi-staged procedures, most of which are technically complex. The ideal single-stage procedures are needed. Ten patients with combined loss of the Achilles tendon and the overlying soft tissue underwent reconstruction using peroneus brevis tendon transfer and reversed sural neurofasciocutaneous flap. Follow-up was 8-48 months. Of the 10 flaps, 9 survived uneventfully except for 1 flap that had distal marginal necrosis; the flap healed following a dressing change. The flaps were wear-resistant and cosmetically acceptable. All the patients were able to perform heel lift with the operated limb and resumed walking. No Achilles tendon re-rupture or misbalance of ankle joints occurred as of date. The Arner-Lindholm evaluation standard was taken to evaluate the curative effect; the results were excellent in seven cases and good in three cases. As a one-stage procedure, the peroneus brevis tendon transfer and reversed sural neurofasciocutaneous flap is an ideal option to reconstruct the combined loss of the Achilles tendon and the overlying soft tissue.