This study aimed to examine the surgical procedure of and complications associated with soft-tissue reconstruction at the insertion of the Achilles tendon. Five patients with skin defects treated between April 2017 and March 2022 were retrospectively examined. Three patients received a reverse sural artery flap, and two received a free radial forearm flap. Patients with a reverse sural artery flap presented with a sensory disorder in the sural nerve region after the sural nerve was raised in the flap. One of the patients with a free radial forearm flap adopted measures to hide the flap collection region with clothing. In our department, the reverse sural artery flap is the first choice for soft-tissue reconstruction at the insertion of the Achilles tendon. However, in cases where the sural nerve is included in the flap, some patients continue to report sural nerve region problems. Therefore, it is necessary to consider a method for raising a flap that does not include the sural nerve. In addition, a radial forearm flap should be considered as an alternative treatment option; however, selection of a free flap other than the radial forearm flap may be preferred by young female patients.
