[Repair of Achilles tendon defect by transplantation of iliotibial band with vascular anastomoses].

OBJECTIVE

To discuss a new operative procedure and the results of transplantation of iliotibial band with vascular anastomoses to repair Achilles tendon defect.

METHODS

The origin, course, branches, distribution and anastomoses of the lateral superior genicular artery and blood supply of iliotibial band were observed on adult lower limbs perfused with red latax. From September 1999 to January 2003, 6 cases of Achilles tendon defects were treated with transplantation of the vascularized iliotibial band by use of microsurgical technique. The area of Achilles tendon defect was 6-11 cm. Six cases of Achilles tendon defects included 4 simple defects and 2 defects with skin defects.

RESULTS

The lateral superior genicular artery originated from the popliteal artery and divided into the ascending branch and descending branch. The ascending branch gave off muscular branch and perforating rami of iliotibial band. The lateral superior genicular artery anatomosed the lateral uppermost genicular artery in the vastus lateralis muscle, and then formed the musculocutaneous perforating rami of iliotibial band. Six patients treated with transplantation of iliotibial band with vascular anastomoses were followed up 6-44 months. The results showed significant improvement in "heel test" and Thompson sign. No complication of ulcer on heel and rerupture of the Achilles tendon occurred.

CONCLUSION

The vascularized iliotibial band is a good donor in reconstruction of Achille tendon defect.