Distally based perforator flaps for reconstruction of post-traumatic defects of the lower leg and foot. A review of the anatomy and clinical outcomes

Tajsic, Nenad B.; Winkel, R.; Husum, Hans

doi:10.1016/j.injury.2013.09.003

Cited by 34 publications

(18 citation statements)

References 47 publications

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Section: Discussionmentioning

confidence: 99%

“…Reconstruction of the lower extremity remains a challenging problem for plastic surgeons, and successful soft tissue reconstruction for exposed tendon, bone, and joint is a determinant factor for limb salvage. 20,21 Local options for reconstruction of this area are limited. Free flaps can provide adequate soft tissue in lower 1/3 cruris reconstruction and are often considered as the first choice for the reconstruction of this area.…”

Section: Discussionmentioning

confidence: 99%

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Coverage of exposed bone and hardware of the medial malleolus with tibialis posterior artery perforator flap after ankle fracture surgery complications

Aksan

Ertekin

et al. 2019

International Wound Journal

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Ankle fractures are among the most common orthopaedic surgical procedures. Skin‐related complications of these surgeries are difficult to reconstruct due to the inadequacy of soft tissue in the region. Although free flaps are generally considered as the first choice in reconstruction of this area, free flaps may not be a suitable option especially in patients with advanced age and comorbidities. Perforator flaps offer a fast and safe alternative in lower extremity reconstruction. In the literature, there are a limited number of studies using perforator flaps in managing the postoperative complications of the lower extremity trauma surgeries. In our study, we report our experience with reconstruction of soft‐tissue defects of medial malleolar region using posterior tibial artery perforator flap for postoperative complications of ankle fracture‐related surgeries.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Coverage of exposed bone and hardware of the medial malleolus with tibialis posterior artery perforator flap after ankle fracture surgery complications

Aksan

Ertekin

et al. 2019

International Wound Journal

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“…Free-flaps is the best method for coverage of soft tissue defects in this area but the procedure is technically difficult, requires skilled surgeons and the recipient site should have suitable vessels which is a big problem in major tibial fractures[16-18]. Perforator-based flaps or a distally-based soleus flap may be suitable for the lower third of the leg but the results are controversial[19-21]. Karbalaeikhani et al[21] used a soleus flap to treat soft tissue defects in the middle and lower third of the leg and reported a high failure rate in the distal third.…”

Section: Discussionmentioning

confidence: 99%

Unhappy triad in limb reconstruction: Management by Ilizarov method

El-Alfy

2017

WJO

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AIMTo evaluate the results of the Ilizarov method in management of cases with bone loss, soft tissue loss and infection.METHODSTwenty eight patients with severe leg trauma complicated by bone loss, soft tissue loss and infection were managed by distraction osteogenesis in our institution. After radical debridement of all the infected and dead tissues the Ilizarov frame was applied, corticotomy was done and bone transport started. The wounds were left open to drain. Partial limb shortening was done in seven cases to reduce the size of both the skeletal and soft tissue defects. The average follow up period was 39 mo (range 27-56 mo).RESULTSThe infection was eradicated in all cases. All the soft tissue defects healed during bone transport and plastic surgery was only required in 2 cases. Skeletal defects were treated in all cases. All patients required another surgery at the docking site to fashion the soft tissue and to cover the bone ends. The external fixation time ranged from 9 to 17 mo with an average of 13 mo. The complications included pin tract infection in 16 cases, wire breakage in 2 cases, unstable scar in 4 cases and chronic edema in 3 cases. According to the association for study and application of methods of Ilizarov score the bone results were excellent in 10, good in 16 and fair in 2 cases while the functional results were excellent in 8, good in 17 and fair in 3 cases.CONCLUSIONDistraction osteogenesis is a good method that can treat the three problems of this triad simultaneously.

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“…es una opción de reconstrucción por considerar aun en pacientes diabéticos, con enfermedad vascular periférica y en tabaquistas. 2,4,8,9 también, se han comunicado buenos resultados cuando el colgajo sural se indicó para tratar pacientes con osteomielitis de tibia distal o calcáneo.…”

Section: Discussionunclassified

“…como falla se consideró necrosis "total" o necrosis "parcial" del colgajo que necesitara de una segunda cirugía para su resolución. 9 en nuestra serie, no se observaron casos de necrosis total, y tres pacientes presentaron necrosis parcial superficial. Blacam y cols.…”

Section: Figura2unclassified

Colgajo fasciocutáneo sural inverso para cobertura de defectos de partes blandas en pierna, tobillo y pie. [Reverse fasciocutaneous sural flap for soft-tissue coverage in the leg, ankle and foot]

Iglesias

Allende

Gutiérrez

et al. 2014

Rev. Asoc. Arg. Ort. y Traumatol

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<div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><span><strong>RESUMEN</strong></span></p><p><span><strong></strong><strong><em>Introducción: </em></strong></span><span>el objetivo de este trabajo es evaluar los resultados obtenidos con la utilización del colgajo fasciocutáneo sural de base distal para la reconstrucción de defectos de partes blandas alrededor de la tibia distal, el tobillo y el pie.</span></p><p><strong><em>Materiales y Métodos: </em></strong><span>se evaluaron, en forma retrospectiva, 20 colgajos pediculados fasciocutáneos surales inversos realizados entre 2007 y 2013. La edad promedio de los pacientes era de 42 años (rango 6-79); 14 hombres y 5 mujeres. Las causas de los defectos fueron: postraumáticas (17 casos, un caso bilateral) y secundarias a resecciones oncológicas (2 casos). La muestra incluyó tres pacientes diabéticos, una mujer obesa y ocho pacientes tabaquistas. En 10 casos, las heridas presentaban exposición tendinosa y, en 10 casos, exposición ósea. El diámetro promedio de los defectos fue de 8,9 x 5,75 cm.</span></p><p><em><strong>Resultados: </strong></em><span>el seguimiento promedio fue de 16 meses. Se logró una exitosa cobertura completa del defecto en los 20 casos. el tiempo promedio de internación fue de 3.15 días. Tres colgajos presentaron necrosis parcial superficial, en un caso el colgajo sufrió necrosis en su tercio distal y, en un paciente, se decidió amputar la extremidad por persistencia de la osteomielitis.</span></p><p><em><strong>Conclusiones: </strong></em><span>Pese a que se han descrito múltiples opciones de cobertura en defectos de tejidos blandos alrededor de la tibia distal, el tobillo y el pie, el colgajo sural inverso es, en la actualidad, uno de los procedimientos más frecuentes para cubrir estos defectos. Se evaluaron 20 colgajos surales inversos y se logró la cobertura completa de los defectos de tejidos blandos, tanto en defectos </span>postraumáticos como en los resultantes de resecciones oncológicas</p><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p> </p></div></div></div></div></div></div>

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Distally based perforator flaps for reconstruction of post-traumatic defects of the lower leg and foot. A review of the anatomy and clinical outcomes

Cited by 34 publications

References 47 publications

Coverage of exposed bone and hardware of the medial malleolus with tibialis posterior artery perforator flap after ankle fracture surgery complications

Coverage of exposed bone and hardware of the medial malleolus with tibialis posterior artery perforator flap after ankle fracture surgery complications

Unhappy triad in limb reconstruction: Management by Ilizarov method

Colgajo fasciocutáneo sural inverso para cobertura de defectos de partes blandas en pierna, tobillo y pie. [Reverse fasciocutaneous sural flap for soft-tissue coverage in the leg, ankle and foot]

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Distally based perforator flaps for reconstruction of post-traumatic defects of the lower leg and foot. A review of the anatomy and clinical outcomes

Cited by 34 publications

References 47 publications

Coverage of exposed bone and hardware of the medial malleolus with tibialis posterior artery perforator flap after ankle fracture surgery complications

Coverage of exposed bone and hardware of the medial malleolus with tibialis posterior artery perforator flap after ankle fracture surgery complications

Unhappy triad in limb reconstruction: Management by Ilizarov method

Colgajo fasciocutáneo sural inverso para cobertura de defectos de partes blandas en pierna, tobillo y pie. [Reverse­ fasciocutaneous­ sural­ flap­ for­ soft-tissue­ coverage­ in­ the­ leg,­ ankle­ and­ foot­]

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Colgajo fasciocutáneo sural inverso para cobertura de defectos de partes blandas en pierna, tobillo y pie. [Reverse fasciocutaneous sural flap for soft-tissue coverage in the leg, ankle and foot]