Free hamstrings tendon transfer and interference screw fixation for less invasive reconstruction of chronic avulsions of the Achilles tendon

Reconstruction of chronic avulsions of the Achilles tendon can be technically difficult, as the calcaneus can be totally denuded of tendon, or only a small tuft of frayed tissue may have remain attached to the calcaneus, and be inadequate to allow a direct repair. In these patients, if it is not possible to directly reattach the Achilles tendon, a tendon graft can be necessary. We developed a less invasive technique using a free semitendinosus tendon graft with interference screw fixation in the calcaneus through a Cincinnati incision. Using this approach, a wide exposure of the insertion of the Achilles tendon is possible, preserving the integrity of the skin overlying the site most prone to wound breakdown.