Gravity Equinus Position to Control the Tendon Length of Reversed Free Tendon Flap Reconstruction for Chronic Achilles Tendon Rupture

Repair of chronic Achilles tendon rupture is a surgical challenge. We describe the use of a free turndown tendon flap augmentation raised from the proximal gastrocnemius aponeurosis. To control optimal tension or the reconstructed Achilles tendon length, we used an original method by referring to the gravity planter flexion ankle angle of the contralateral limb. Key aspects of the technique are described. A retrospective analysis of the short-term outcomes achieved in a case series (n = 56) is presented. The postoperative anthropometric findings are also presented to indicate the successful outcomes achieved with this technique.