Composite Cutaneous Anterolateral Thigh Flap with Rolled Fascia Lata for Tibialis Anterior Tendon Reconstruction.

MedStar author(s):
Citation: Plastic and Reconstructive Surgery - Global Open. 8(7):e2959, 2020 Jul.PMID: 32802653Institution: MedStar Washington Hospital CenterDepartment: Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020ISSN:
  • 2169-7574
Name of journal: Plastic and reconstructive surgery. Global openAbstract: Conclusions: The use of this donor site offers a novel, advantageous option for TAT repair. It should be considered for patients with large defects that make other repair methods unfeasible. Copyright (c) 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.Methods: We present a unique case of traumatic TAT rupture with a failed primary closure yielding a large (>15 cm) defect. The patient presented with a defect spanning the entire anterior compartment of the leg, limiting options for coverage and functional restoration.Results: The patient's large, chronic defect was successfully repaired via a composite cutaneous anterolateral thigh and a rolled fascia lata free flap. The patient had robust return to function and is able to dorsiflex and invert the foot and ambulate.Rupture of the tibialis anterior tendon (TAT) is a rare phenomenon with limited therapeutic options derived from sparse case reports. Without proper anchoring of the tibialis anterior, dorsiflexion and inversion of the foot become impaired, disrupting patient's gait. Reported techniques for repair fall into nonoperative (ankle-foot orthosis) or operative (primary closure, tendon transfer, free gracilis) modalities, depending on patient factors, mechanism of injury, and extent of defect. In this report, we outline a novel method of tendon repair and soft tissue coverage for a large defect.All authors: Bekeny JC, Evans KK, Fan KL, Zolper EGFiscal year: FY2021Digital Object Identifier: Date added to catalog: 2020-09-02
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Journal Article MedStar Authors Catalog Article 32802653 Available 32802653

Conclusions: The use of this donor site offers a novel, advantageous option for TAT repair. It should be considered for patients with large defects that make other repair methods unfeasible. Copyright (c) 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

Methods: We present a unique case of traumatic TAT rupture with a failed primary closure yielding a large (>15 cm) defect. The patient presented with a defect spanning the entire anterior compartment of the leg, limiting options for coverage and functional restoration.

Results: The patient's large, chronic defect was successfully repaired via a composite cutaneous anterolateral thigh and a rolled fascia lata free flap. The patient had robust return to function and is able to dorsiflex and invert the foot and ambulate.

Rupture of the tibialis anterior tendon (TAT) is a rare phenomenon with limited therapeutic options derived from sparse case reports. Without proper anchoring of the tibialis anterior, dorsiflexion and inversion of the foot become impaired, disrupting patient's gait. Reported techniques for repair fall into nonoperative (ankle-foot orthosis) or operative (primary closure, tendon transfer, free gracilis) modalities, depending on patient factors, mechanism of injury, and extent of defect. In this report, we outline a novel method of tendon repair and soft tissue coverage for a large defect.

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