Free fibular composite tissue flap with peroneus longus and brevis for complicated extremity trauma
10.3760/cma.j.issn.1671-7600.2019.10.003
- VernacularTitle: 带腓骨长短肌的游离腓骨复合组织瓣在复杂肢体创伤中的应用
- Author:
Yunchu SUN
1
,
2
;
Gen WEN
2
;
Jia XU
2
;
Fengji XU
3
;
Yimin CAI
2
Author Information
1. Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
2. Department of Orthopaedics, The Sixth People's Hospital of Shanghai, Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
3. Department of Emergency, Shanghai Qingpu District Zhujiajiao People's Hospital, Shanghai 200233, China
- Publication Type:Journal Article
- Keywords:
Surgical flaps;
Fibula;
Composite tissue defects;
Fibular osteocutaneous flap
- From:
Chinese Journal of Orthopaedic Trauma
2019;21(10):839-842
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To report our clinical application of free fibular composite tissue flap with peroneus longus and brevis in the treatment of complicated extremity trauma.
Methods:From August 2014 to September 2017, 5 patients with complicated extremity trauma were treated using a free fibular composite tissue flap with peroneus longus and brevis at Department of Orthopaedics, The Sixth People's Hospital of Shanghai. They were 4 men and one woman, aged from 23 to 52 years (average, 35.1 years). All of them had tendon defects; one had a radius defect, one an ulnar defect and three a tibial defect. The length of bone defects ranged from 8 cm to 18 cm; the size of soft tissue defects ranged from 10 cm × 5 cm to 18 cm ×8 cm. A fibular composite tissue flap was designed according to the soft tissue condition and defect area to repair and fixate the bone defect after thorough debridement and cover the wound before functional reconstruction. Postoperatively, survival of the flap and functional recovery of the corresponding tendon at the recipient site, healing time of the tibia, and wound healing, ankle motion and complications at the donor site were all observed.
Results:The 5 patients were followed up for 18 to 38 months (average, 25.2 months). All flaps survived without any vascular crisis or infection. The union time for the fibular graft ranged from 4 to 16 months (average, 8.4 months). In the 3 patients with a tibial defect, the maximum angle of dorsal extension ranged from 0° to 10° and no foot drop was observed. Thumb and digital flexion was reconstructed in the patients with a forearm bone defect only to achieve opposition of index finger and thumb but we failed to make them have a fist. At the 5 flap donor sites, the wound was sutured by the second stage after vacuum suction and healed well; obvious scar formed in one of them. No obvious foot varus was observed at the donor site. The patients were satisfactory with their ankle joint motion. No refracture of the fibular graft occurred during follow-up.
Conclusion:A free fibular composite tissue flap with peroneus longus and brevis is a good choice for complicated extremity trauma.
