The head of second metatarsal bone and flap repair the lateral malleolus compound tissues defect in children
10.3760/cma.j.cn114453-20190411-00125
- VernacularTitle:第2跖骨头复合组织瓣重建小儿外踝骨皮肤缺损
- Author:
Shuming ZHAO
1
;
Na LI
;
Xueliang LIU
;
Hongliang ZHANG
;
Zhanfeng SONG
;
WenHua GAO
;
Anwei FAN
;
Yuehui LAN
Author Information
1. 冀中能源邢台矿业集团有限责任公司总医院骨三科 054000
- Keywords:
Metatarsal bones;
Surgical flap;
Ankle injury;
Child
- From:
Chinese Journal of Plastic Surgery
2020;36(10):1139-1143
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinic effects of the head of second metatarsal bone and flap for bone and skin defect at lateral malleolus in children.Methods:Between July 2009 and May 2018, 4 children with ankle bone and skin and soft tissue defects in the Jizhong Energy Xingtai Mig General Hospital were selected, including 3 boys and 1 girl aged 4-13 years old. All cases were lateral malleolus defect with adjacent skin defect, the range of skin defect was 2.0 cm×2.0 cm -4.0 cm×5.0 cm, and the range of bone defect was 1.0-3.0 cm. The area of the flap was 2.5 cm×2.5 cm-4.5 cm × 5.5 cm, and the length of the second metatarsal head was 1.0-3.0 cm. The donor site was closed directly. After the operation, X-rays was performed to evaluate whether the ankle space and lateral malleolus longitudinal development was synchronized with the uninjured limb. Ankle joint function recovery was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS). The outcomes of donor foot range of motion, weight-bearing, and walking were observed.Results:All the composite tissue flap survived with good blood circulation, and all the donor sites healed well. All the child patients were followed up for 0.5-2.0 years. The color and elasticity of the flaps were good, without cicatricial contracture. The patients had no inversion of ankle joint, with satisfying loading and walking function. Imaging evaluation showed that the space between ankle points and the longitudinal development of lateral malleolus were roughly synchronous with the healthy side. Two cases were graded as excellent and 2 as good according to the standard of the AOFAS.The donor's foot had normal flexion and extension function, without instability.Conclusions:The head of second metatarsal bone and flap can repair the epiphysis and soft tissue defect of lateral malleolus in children at one stage, and the reconstructed lateral malleolus can develop with the growth of children. It is a satisfactory method of reconstructing the traumatic defect of lateral malleolus in children.
