Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Burn Unit, Istanbul, Turkey.
Microsurgery. 2013 Mar;33(3):223-6. doi: 10.1002/micr.22065. Epub 2012 Dec 26.
Tensor fascia latae (TFL) myocutaneous flap, utilized as a novel approach for the successful functional repair of the foot drop deformity is presented in this case report. A 21-year-old male patient was subjected to a close-range high-velocity gunshot injury and sustained comminuted Gustillo-type IIIB open fracture of his left tibia. A composite skin and soft tissue defect including tibialis anterior and extansor hallucis longus tendons was determined. The injury was managed in two stages. In the first stage, the immediate reconstruction of the open tibia fracture was provided by using a reverse flow sural flap and external fixation of the fracture. The functional restoration was achieved by vascular fascia latae in the second stage, 6 months after the initial skin, soft tissue, and bone defect repair. The functional recovery was successful, and the foot drop gait was almost totally ameliorated. Reconstruction with TFL flap should be retained in the armamentarium for the functional repair of the foot drop deformity, caused by composite skin and soft tissue defects of the pretibial region.
本文报告了一例采用阔筋膜张肌肌皮瓣（TFL）作为一种新颖方法成功修复足下垂畸形的病例。一名 21 岁男性患者因近距离高速枪击伤导致左胫骨粉碎性 Gustillo ⅢB 型开放性骨折。该患者存在包括胫骨前肌和踇长伸肌腱在内的复合皮肤和软组织缺损。该损伤分两期进行治疗。在第一期，通过使用逆行腓肠神经营养血管皮瓣和骨折外固定来即刻重建开放性胫骨骨折。在初始皮肤、软组织和骨缺损修复后 6 个月的第二期，通过血管化阔筋膜进行功能恢复。功能恢复成功，足下垂步态几乎完全改善。对于前胫区复合皮肤和软组织缺损导致的足下垂畸形，TFL 皮瓣的重建应作为功能修复的手段保留。
