One-stage reconstruction of complex lower extremity deformity combining Ilizarov external fixation and sural neurocutaneous flap.

BACKGROUND

Complex lower extremity deformities include multidirectional foot and ankle deformities, which are complicated therapeutic and surgical challenges. Correction often requires several stages, which is time consuming and costly. The need to restore the physical, mechanical, and cosmetic aspects of the lower extremity results in a difficult balancing act between these concerns and the deformity correction and soft tissue reconstruction.

METHODS

Between January 2009 and September 2011, we treated 5 patients with multidirectional foot and ankle deformities. Significant mobility limitation was caused by abnormal scarring, which led to abnormal gait and weight-bearing regions. We used a sural neurocutaneous flap to repair the soft tissue defects after scar-tissue removal in all patients and placed a circular hinged Ilizarov external fixator for gradual correction.

RESULTS

All the flaps survived and resulted in good texture match and contour. The follow-up period was 19 to 26 months. The correction lasted 3 to 5 months, and all of the patients were able to walk with satisfactory gaits and without assistance. We encountered no complications, such as pin-track infection or drop foot in our series.

CONCLUSION

Our approach, combining a sural neurocutaneous flap and Ilizarov external fixation, was a reliable and effective tool for one-stage reconstruction of complex lower extremity deformities.