Free flaps have recently become the first preference for complex foot defects, with many advantages including ability to present suitable and adequate tissue, to enhance blood flow of the extremity, and to decrease risk of osteomyelitis. A 25-year-old male patient was referred to us with a complex injury of the left foot due to mine explosion. We successfully restored the defect with the ipsilateral free vascularized fibula osteocutaneous flap. The flap survived completely. After 8 weeks postoperatively, the patient began to walk. An adequate foot contour was achieved, and both the transverse and longitudinal arches were reestablished. Recovery of the donor site was also good. The free fibula osteocutaneous flap was able to present a composite tissue required in a defective foot, by leaving single donor site morbidity in one session. We believe that this flap may be a preferred option in complex foot defects.
Cutis verticis gyrata (CVG) is a very rare morphological condition of the scalp characterized by ridges and furrows resembling the surface of the brain. Primary or idiopathic CVG occurs in the absence of underlying soft-tissue abnormalities and is often associated with neuropsychiatric disorders. Secondary CVG occurs as a result of a local inflammatory or neoplastic process of the scalp or a systemic illness that produce pathologic changes in the scalp structure. The choice of treatment of CVG is surgical repair which depends on the size and location of the lesion, the underlying disorder, and the wishes of the patient, including primary repair, serial excision, skin grafting, local flaps and tissue expansion. In this case report, we describe the first female patient in the published work with primary essential CVG that appeared at 30 years of age. Because the patient had no cosmetic or functional complaint, no surgical intervention was attempted. Primary essential CVG, a very uncommon disorder, may be encountered in females after the third decade. The classification of CVG is essential to properly diagnose and treat patients who present with these unusual scalp lesions.
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