Distally based hemisoleus flap for soft tissue defect closure following chronic osteomyelitis of the distal tibia: A case report.

Autor:	Johan MP; Department of Orthopaedics and Traumatology, Dr. Wahidin Sudirohusodo General Hospital - Faculty of Medicine Hasanuddin University, Makassar, Indonesia. Electronic address: muhpjo@gmail.com., Nong I; Department of Orthopaedics and Traumatology, Dr. Wahidin Sudirohusodo General Hospital - Faculty of Medicine Hasanuddin University, Makassar, Indonesia., Saleh R; Department of Orthopaedics and Traumatology, Dr. Wahidin Sudirohusodo General Hospital - Faculty of Medicine Hasanuddin University, Makassar, Indonesia., Subagio ES; Department of Orthopaedics and Traumatology, Dr. Wahidin Sudirohusodo General Hospital - Faculty of Medicine Hasanuddin University, Makassar, Indonesia. Electronic address: erich.subagio@gmail.com., Asy'arie AP; Department of Orthopaedics and Traumatology, Dr. Wahidin Sudirohusodo General Hospital - Faculty of Medicine Hasanuddin University, Makassar, Indonesia., Kawilarang MA; Department of Orthopaedics and Traumatology, Dr. Wahidin Sudirohusodo General Hospital - Faculty of Medicine Hasanuddin University, Makassar, Indonesia.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2021 Oct; Vol. 87, pp. 106437. Date of Electronic Publication: 2021 Sep 21.
DOI:	10.1016/j.ijscr.2021.106437
Abstrakt:	Introduction and Importance: Chronic osteomyelitis often needs extensive debridement that leaves a gap and needs soft tissue reconstruction procedure. The use of pedicled versus free flap to reconstruct soft tissue following surgical debridement has long been debated. Pedicle flap is more favored by many surgeons for the distal third tibia, mainly due to its lower failure rate. Case Presentation: We report a 33-year-old man with eight years of chronic osteomyelitis treated with surgical debridement at the distal third tibia, leaving a 5 cm × 6 cm soft tissue defect with exposed bone. Against the common preference, we performed a distally based hemisoleus flap (pedicled flap) covered with a split thickness skin graft. No signs of flap/graft rejection were observed during follow-up, and the patient was able to return to work four months following the surgery. No limitation in patient's daily activity upon two years follow up. Clinical Discussion: Preservation of critical perforators is essential during the elevation of the flap. The knowledge and application of the vascularity and angiosome principles are crucial in designing this type of flap, as some anatomical variations do exist. Meticulous tissue handling is required to support the basic knowledge of the lower limb vascular system. Conclusion: Distally based hemisoleus flap is a reasonable option for soft tissue defect following chronic osteomyelitis of the distal tibia. (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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