Achilles tendon rupture is often complicated by skin substance loss around the tendon, which is a poorly-vascularized site. Treatment may be conservative or surgical, but the former is not generally accepted by the orthopedic community and is reserved for selected cases, while surgery remains the mostwidely-used approach. Soft tissue repair at this site is a crucial reconstruction problem, and becomes very complex if skin reconstruction has to be associated with a complex tendon repair. The Authors describe a new approach to the repair of Achilles tendon substance loss compounded by a soft tssue defect, using a cryopreserved gracilis tendon allograft in combination with a distally-based adipofascial sural flap.