The Role of the Very Long Posterior Tibial Artery Flap following Severe Lower Limb Trauma

Abstract

Summary:With advancing techniques, knowledge, and training, the decision to salvage a lower limb following severe trauma is becoming ever more popular and successful. However, in cases where amputation is inevitable due to extensive injury or infection, we encourage the use of the very long posterior tibial artery (VLPTA) flap when the sole of the foot and posterior tibial neurovasculature are intact. We report 3 patients who underwent below-knee amputation and reconstruction using the VLPTA flap. A literature review was also performed to identify the outcomes and any complications associated with VLPTA flap.

The pedicled fillet‐of‐sole flap as a reconstructive option for stump reconstruction in chronic osteomyelitis

“…Its use in cases of chronic osteomyelitis is less well‐known and restricted to four case series, with a total of seven patients, published between 1994 and 2017. In all four cases, the patients had been treated for chronic osteomyelitis for between two and 10 years prior and had previously undergone multiple debridements 4–7 . Adding to the scant literature, we present our own case report to raise awareness of the utility of the PFOS flap in chronic lower limb osteomyelitis.…”

“…The PFOS flap remains an underutilized reconstructive option in cases of chronic osteomyelitis of the lower limb 4–7 . The challenge in these circumstances is that the soft tissue is chronically inflamed, rendering the tissue woody and destroying planes.…”

“…In all four cases, the patients had been treated for chronic osteomyelitis for between two and 10 years prior and had previously undergone multiple debridements. [4][5][6][7] Adding to the scant literature, we present our own case report to raise awareness of the utility of the PFOS flap in chronic lower limb osteomyelitis.…”

“…The PFOS flap remains an underutilized reconstructive option in cases of chronic osteomyelitis of the lower limb. [4][5][6][7] The challenge in these circumstances is that the soft tissue is chronically inflamed, rendering the tissue woody and destroying planes. If the dissection is unsuccessful, a free fillet-of-sole flap with the tibial nerve maintained in continuity is a good back-up option.…”