[Free radial forearm flap transfer for the reconstruction of the Achilles tendon and soft tissue defect: a case report].

Reconstruction of the soft tissue defects around the Achilles tendon is a difficult challenge. This condition traditionally has been treated with staged procedures. We report a case treated with a one stage procedure. A neuromusculocutaneous radial forearm free flap was used for the reconstruction of an achilles tendon and for covering the overlying large soft tissue defect caused by a gun shot injury. The defect on the Achilles tendon was 15 cm in length and soft tissue loss was 18 x 10 cm. The flap including flexor carpi radialis muscle tendon was applied over the Achilles tendon. A terminolateral arterial anostomosis was performed on the tibialis posterior artery. There was no complication except a mild superficial infection on the lateral side of the flap treated by antibiotherapy. A satisfactory functional result was obtained. Application of a free neuromusculocutaneous radial forearm composite flap is a good technique to cover achilles tendon and soft tissue defects and to restore the function as a one stage procedure.