- 期刊
Microsurgical Reconstruction for Combined Achilles Tendon Defect with Soft Tissue Loss-The Comparison Between Free Flap and Free Functional Muscle Transfers
使用功能性游離皮瓣與單純性游離皮辦重建足跟腱斷裂之結果比較
並列摘要
Post-traumtic Achilles tendon defect combined with chronic soft tissue loss is a difficult clinical problem. In this study, we compared the outcomes of patients receiving innervated and non-innervated microvascular gracilis muscle free flaps for the reconstruction of combined Achilles tendon and soft tissue defects. Eighteen patients (12 male and 6 female) underwent reconstruction for their Achilles tendon loss between 1995 and 1998. All 18 had local soft tissue defect, chronic infection, and a walking problem. Half of our cases (group 1) received free gracilis muscle transfers, and the other half (group 2) received innervated free gracilis muscle transfers that anastomosed with nerve branches from posterior tibial nerve. Post-operative evaluations of torque and power using the Cybex II dynamometer, electromyographic (EMG) activity, as well as functional assessment were performed. The use of the innervated muscle flap was found to produce more satisfactory result with better muscle torque recovery. This functional muscle transfer is suitable cases such as those of athletes or patients whose daily physical activities are demanding.