[Reverse anterolateral thigh flap for repair of wound defects with exposed tibia].

OBJECTIVE

To investigate the method and effectiveness of reverse anterolateral thigh flap and muscle flap for repair of wound defects with exposed tibia in the proximal-middle leg.

METHODS

Between October 2005 and April 2010, 16 patients with wound defects with exposed tibia in the proximal-middle leg were treated with reverse anterolateral thigh flap and muscle flap. There were 10 males and 6 females, aged from 16 to 52 years. Injury was caused by traffic accident in 11 cases and by crushing in 5 cases. The disease duration of 1-6 hours (mean, 3 hours) in 10 patients and 6-14 days (mean, 10 days) in 6 patients, who underwent tibial fracture plate fixation in other hospitals. The size of wound ranged from 13 cm x 7 cm to 20 cm x 13 cm. The size of the flap ranged from 16 cm x 10 cm to 23 cm x 15 cm. The donor sites were covered with splite thickness skin grafts.

RESULTS

Infection occurred in 2 flaps at 5-7 days and was cured after 1 week of dressing change; the other flaps survived and the wounds healed by first intention. The incisions healed well and the skin grafts survived at the donor sites. All cases were followed up 10-23 months (mean, 18 months). The appearance of the flap was slightly overstaffed, but the color and texture were satisfactory. All fractures healed at 8-10 months after operation.

CONCLUSION

It is effective to repair wound defects with exposed tibia in the proximal-middle leg with reverse anterolateral thigh flap and muscle flap.