Free latissimus dorsi myocutaneous flap combined with tibial bone extension saves the calf on the verge of amputation: a case report
10.3760/cma.j.cn441206-20240128-00030
- VernacularTitle:游离背阔肌肌皮瓣联合胫骨骨延长挽救濒临截肢小腿1例
- Author:
Sulong WANG
1
;
Yusufu AIHEMAITIJIANG
1
Author Information
1. 新疆医科大学第一附属医院骨科中心显微修复外科 新疆创伤修复重建重点实验室，乌鲁木齐 830054
- Publication Type:Journal Article
- Keywords:
Latissimus dorsi myocutaneous flap;
Bone defect;
Bone lengthening;
Tibia
- From:
Chinese Journal of Microsurgery
2024;47(6):698-701
- CountryChina
- Language:Chinese
-
Abstract:
In January 2021, a 48-year old patient with an extensive open fracture and an infection in left calf was treated in the Microsurgical Orthopaedic Centre, the First Affiliated Hospital of Xinjiang Medical University. After the thorough debridement and successful infection control, a large soft tissue defect (32.0 cm×25.0 cm) in the left calf was reconstructed using a 35.0 cm×8.0 cm free latissimus dorsi myocutaneous flap which also facilitated the replacement of damaged Achilles tendon. The large area of wound in anterior tibia was covered with a medium-thickness skin graft. The 13.0 cm defect of left tibial bone was reconstructed by an in situ bone lengthening from the fractured left tibia in the stage Ⅱ surgery. At the 23-month postoperative follow-up, the flap survived well, with the Achilles tendon had regained a muscle strength at grade Ⅲ. Sensation was improved to S 4 in the weight-bearing areas of left foot, with TPD of 15 mm. The fracture of the extended tibial segment healed well. Overall function of the left ankle was rated as good using the American Orthopedic Foot and Ankle Society (AOFAS) standards.
