Reconstruction of proximal tibial defect with infection and soft tissue defect after resection of giant cell tumour of tendon sheath with microsurgical technique: a case report
10.3760/cma.j.cn441206-20250227-00044
- VernacularTitle:腱鞘巨细胞瘤切除术后感染性胫骨近端骨缺损合并软组织缺损重建1例
- Author:
Lin TIAN
1
;
Liuchao CUI
1
;
Faxiang LI
1
;
Yuzhong TAN
1
;
Liangkun CHENG
1
;
Yun ZHENG
1
Author Information
1. 重庆长城骨科医院手显微外科,重庆 400041
- Publication Type:Journal Article
- Keywords:
Anterolateral thigh myocutaneous flap;
Iliac bone flap;
Tibia;
Giant cell tumour of tendon sheath;
Microsurgical technique
- From:
Chinese Journal of Microsurgery
2025;48(4):465-469
- CountryChina
- Language:Chinese
-
Abstract:
On 25th September 2021, a patient was admitted in the Department of Hand Microsurgery, Chongqing Great Wall Orthopaedic Hospital with an infectious proximal tibia defect and soft tissue defect after the resection of a giant cell tumour of tendon sheath (GCTTS). After relevant examinations, it was found that there was a large bone defect at proximal medial tibia, with an extremely thin of medial tibial plateau. Size of bone defect was 8.0 cm×3.5 cm×3.0 cm, and soft tissue defect was 6.0 cm×8.0 cm. A phased surgery was planned: firstly, the internal fixation was removed with thorough debridement and then the cavity was filled by antibiotic bone cement for control of the infection; In the phase-Ⅱ surgery, a series of anterolateral thigh myocutaneous flap (the volume of the muscle flap was 6.0 cm×2.5 cm×2.0 cm, and the size of flap was 4.0 cm×9.0 cm) and an iliac bone flap were used and the cavity of medial proximal tibia was filled with calcium sulphate and anterolateral thigh muscle graft. A piece of iliac bone graft was transferred to support the tibial plateau, and the wound was covered by flap (the volume of the iliac bone fragment was 12.0 cm×5.0 cm×2.0 cm, and the size of flap was 4.0 cm×9.0 cm). At 3 years of postoperative follow-up, the fracture healed well, the cavity at medial proximal tibia was significantly reduced. Appearance of flaps was good with restored protective sensation. Function of the affected knee was close to normal with a score of 94 according to Lysholm Knee Scale.
