Basile Attilio, Stopponi Marcello, Loreti Andrea, Minniti de Simeonibus Angelo Ugo
Department of Orthopaedic and Trauma Surgery, Ospedale San Giovanni-Addolorata, Rome, Italy.
J Foot Ankle Surg. 2008 Mar-Apr;47(2):112-7. doi: 10.1053/j.jfas.2007.12.005.
One of the goals in the management of severe open injuries of the foot is to obtain adequate soft tissue coverage. In extreme conditions of pedal soft tissue loss, in patients who are not satisfactory candidates for local or free-tissue transfer, the cross-leg flap remains an option for surgical reconstruction. We present the results of 7 patients with multiple lower limb open fractures associated with ipsilateral degloving injuries, and/or secondary pressure ulcers of the hindfoot with exposure of the calcaneus, in which a distally based sural artery island fasciocutaneous flap, elevated from the contralateral leg and crossed to the injured side, was used to repair the soft tissue defect of the recipient heel. All of the flaps survived and the soft tissues healed uneventfully, thereby providing satisfactory and stable coverage of the calcaneal tuberosity. To the best of our knowledge, this is the first report in which this technique has been used to repair hindfoot soft tissue defects associated with complex bone and vascular injuries of the lower limb in polytrauma patients.
足部严重开放性损伤治疗的目标之一是获得足够的软组织覆盖。在足部软组织严重缺失的极端情况下，对于不适合进行局部或游离组织移植的患者，交腿皮瓣仍是手术重建的一种选择。我们报告了7例伴有同侧脱套伤的多发性下肢开放性骨折患者，和/或后足继发性压疮伴跟骨外露，采用从对侧小腿掀起并交叉至伤侧的远端蒂腓肠动脉岛状筋膜皮瓣修复受区足跟软组织缺损的结果。所有皮瓣均存活，软组织愈合良好，从而为跟骨结节提供了满意且稳定的覆盖。据我们所知，这是首次报道该技术用于修复多发伤患者下肢复杂骨与血管损伤相关的后足软组织缺损。
4级。
