Microsurgery Unit, Department of Plastic, Reconstructive and Aesthetic Surgery, Univ Paris Diderot, Sorbonne Paris Cité, AP-HP, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75475 Paris Cedex 10, France.
J Plast Reconstr Aesthet Surg. 2013 Dec;66(12):1798-800. doi: 10.1016/j.bjps.2013.04.064. Epub 2013 Jun 22.
The reconstruction of severe defects of the ankle and foot is a challenge. The ideal solution should combine a thin skin flap on the dorsum to allow shoe fitting and a muscle flap with a split-thickness skin graft on the weight-bearing area. Perforator-based thoracodorsal chimaeric flaps allow us to achieve these two goals with minimal donor-site morbidity. We present a reconstruction of an extended circumferential defect of the ankle with an exposed heel using a chimaeric thoracodorsal perforator flap with a serratus muscle flap. The skin flap was transferred on the dorsal foot, whereas the serratus anterior muscle was transferred on the exposed heel. Postoperative recovery was uneventful and the patient began full weight bearing after 3 months. Twelve months after reconstruction, natural shape and walking function were successfully achieved.
严重的踝部和足部缺损的重建是一个挑战。理想的解决方案应结合在背侧的薄皮瓣以适应鞋子，并结合在负重区带有断层皮片的肌肉瓣。基于穿支的胸背联合嵌合皮瓣可使我们以最小的供区发病率达到这两个目标。我们展示了使用带有胸背肌的胸背穿支嵌合皮瓣重建扩展的环形踝部和后跟外露缺损的病例。皮瓣转移到足背，而胸大肌转移到暴露的跟骨。术后恢复顺利，患者在 3 个月后开始完全负重。重建后 12 个月，成功地恢复了自然形态和行走功能。
