We report two cases that underwent reconstruction using a free anterolateral thigh flap combined with fascia lata and iliotibial ligament for the treatment of infected extensive Achilles tendon defects. Both cases had previously undergone multiple debridements for reconstructed Achilles tendon infections following the Lindholm procedure. As a result, they had Achilles tendon defects measuring 13 cm and 13.5 cm in length for Case 1 and Case 2, respectively. Subsequent reconstruction of the Achilles tendon and soft tissue defects was performed using a free anterolateral thigh flap incorporating the fascia lata and iliotibial ligament. Case 1 achieved normal gait (10o of dorsiflexion and 35o of plantar flexion) . The patient was able to stand on both tiptoes 18 months postoperatively. Case 2 achieved normal gait (15o of dorsiflexion and 30o of plantar flexion) . The patient could jog and stand on tiptoe on the affected side 12 months postoperatively. Free anterolateral thigh flap combined with the fascia lata and iliotibial ligament is a useful option for the reconstruction of infected extensive Achilles tendon defects.
