A 49-year-old man presented with skin necrosis and soft tissue defects at the right Achilles tendon area after tendon rupture repair. The posterior tibial artery was also damaged. We performed a reconstruction using a medial fasciocutaneous flap (and distally based pedicle). After 2 weeks, the wound healed, and the tissue defect was overcome. We found that the medial fasciocutaneous flap at the posterior leg can be raised easily and can be a simple choice to resolve tissue defects in the Achilles tendon area. This type of flap can help reconstruct tissue defects in acute wounds early.
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