Abstract
Over the past 4 years, a total of 33 patients, each with an open tibial wound in the distal third of the leg, underwent a skin-grafted muscle flap reconstruction according to the new treatment algorithm developed by the author. When the size of the soft-tissue defect was less than 50 cm, a pedicled medial hemisoleus muscle flap was used for the soft-tissue coverage (n = 20). If the soleus muscle was traumatized, a small free muscle flap (ie, gracilis) was then used (n = 3). When the size of the soft-tissue defect was greater than 50 cm, a larger free muscle flap (ie, rectus abdominis or latissimus dorsi) was selected (n = 10). All patients were followed for up to 4 years. Three patients with a medial hemisoleus muscle flap developed insignificant distal flap necrosis and were treated subsequently with debridement and flap advancement. Five patients with a free muscle flap required an additional operation, and 2 patients had a subsequent debulking procedure of the flap for contour improvement of the leg. Reliable soft-tissue coverage with a well-healed tibial wound, evident fracture healing, and good contour of the leg were achieved in all 33 patients during follow-up. Following this new treatment algorithm, a selected option for an open tibial wound in the distal third of the leg can provide reliable soft-tissue coverage for different sizes of open tibial wounds and may offer a more cost-effective approach for managing such a complex clinical problem.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 78-83 |
| Number of pages | 6 |
| Journal | Annals of Plastic Surgery |
| Volume | 58 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2007 |
| Externally published | Yes |
Fingerprint
Keywords
- Distal leg
- Muscle flap
- Reconstruction
- Tibial wound
- Treatment algorithm
ASJC Scopus subject areas
- Surgery
Cite this
Soft-tissue reconstruction of an open tibial wound in the distal third of the leg : A new treatment algorithm. / Pu, Lee Li-Qun.
In: Annals of Plastic Surgery, Vol. 58, No. 1, 01.2007, p. 78-83.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Soft-tissue reconstruction of an open tibial wound in the distal third of the leg
T2 - A new treatment algorithm
AU - Pu, Lee Li-Qun
PY - 2007/1
Y1 - 2007/1
N2 - Over the past 4 years, a total of 33 patients, each with an open tibial wound in the distal third of the leg, underwent a skin-grafted muscle flap reconstruction according to the new treatment algorithm developed by the author. When the size of the soft-tissue defect was less than 50 cm, a pedicled medial hemisoleus muscle flap was used for the soft-tissue coverage (n = 20). If the soleus muscle was traumatized, a small free muscle flap (ie, gracilis) was then used (n = 3). When the size of the soft-tissue defect was greater than 50 cm, a larger free muscle flap (ie, rectus abdominis or latissimus dorsi) was selected (n = 10). All patients were followed for up to 4 years. Three patients with a medial hemisoleus muscle flap developed insignificant distal flap necrosis and were treated subsequently with debridement and flap advancement. Five patients with a free muscle flap required an additional operation, and 2 patients had a subsequent debulking procedure of the flap for contour improvement of the leg. Reliable soft-tissue coverage with a well-healed tibial wound, evident fracture healing, and good contour of the leg were achieved in all 33 patients during follow-up. Following this new treatment algorithm, a selected option for an open tibial wound in the distal third of the leg can provide reliable soft-tissue coverage for different sizes of open tibial wounds and may offer a more cost-effective approach for managing such a complex clinical problem.
AB - Over the past 4 years, a total of 33 patients, each with an open tibial wound in the distal third of the leg, underwent a skin-grafted muscle flap reconstruction according to the new treatment algorithm developed by the author. When the size of the soft-tissue defect was less than 50 cm, a pedicled medial hemisoleus muscle flap was used for the soft-tissue coverage (n = 20). If the soleus muscle was traumatized, a small free muscle flap (ie, gracilis) was then used (n = 3). When the size of the soft-tissue defect was greater than 50 cm, a larger free muscle flap (ie, rectus abdominis or latissimus dorsi) was selected (n = 10). All patients were followed for up to 4 years. Three patients with a medial hemisoleus muscle flap developed insignificant distal flap necrosis and were treated subsequently with debridement and flap advancement. Five patients with a free muscle flap required an additional operation, and 2 patients had a subsequent debulking procedure of the flap for contour improvement of the leg. Reliable soft-tissue coverage with a well-healed tibial wound, evident fracture healing, and good contour of the leg were achieved in all 33 patients during follow-up. Following this new treatment algorithm, a selected option for an open tibial wound in the distal third of the leg can provide reliable soft-tissue coverage for different sizes of open tibial wounds and may offer a more cost-effective approach for managing such a complex clinical problem.
KW - Distal leg
KW - Muscle flap
KW - Reconstruction
KW - Tibial wound
KW - Treatment algorithm
UR - http://www.scopus.com/inward/record.url?scp=33846011863&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33846011863&partnerID=8YFLogxK
U2 - 10.1097/01.sap.0000250744.62655.38
DO - 10.1097/01.sap.0000250744.62655.38
M3 - Article
C2 - 17197948
AN - SCOPUS:33846011863
VL - 58
SP - 78
EP - 83
JO - Annals of Plastic Surgery
JF - Annals of Plastic Surgery
SN - 0148-7043
IS - 1
ER -