Distally based hemisoleus flap for soft tissue defect closure following chronic osteomyelitis of the distal tibia: A case report
| Autor: | Ruksal Saleh, Ahmad Perdana Asy'arie, Maxmillian Alexander Kawilarang, Erich Svante Subagio, Ira Nong, Muhammad Phetrus Johan |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | 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. Highlights • Surgery is the cornerstone of effective management for chronic osteomyelitis. • Distally based hemisoleus flap for defect coverage in the medial distal tibia • The good functional outcome can be achieved after distally based hemisoleus flap. |
| Databáze: | OpenAIRE |
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