Multilayer reconstructions for defects overlying the Achilles tendon with the lateral-arm flap: long-term follow-up of 16 cases. 
Defects of the Achilles tendon and the overlying soft tissue are challenging to reconstruct.  The lateral-arm flap has our preference in this region as it provides thin pliable skin, in addition, the fascia and tendon can be included in the flap as well.  The aim of this report is to share the experience the authors gained with this type of reconstruction.  The authors report the largest series in the published reports today.  A retrospective review was performed of all patients treated between January 2000 and January 2009 with a lateral-arm flap for a soft-tissue defect overlying the Achilles tendon.  In the reviewed period, 16 soft-tissue defects overlying the Achilles tendon were reconstructed, with a mean follow-up of 63 months.  In three cases, tendon was included into the flap and in two, a sensory nerve was coapted.  Fifteen cases (94%) were successful, one failed.  In seven cases, a secondary procedure was necessary for thinning of the flap.  The lateral-arm flap is a good and safe option for the reconstruction of defects overlying the Achilles tendon.