Department of Foot and Ankle, 74735Wuxi NO.9 People's Hospital Affiliated to Soochow University, Wuxi, P. R. China.
J Orthop Surg (Hong Kong). 2022 Jan-Apr;30(1):10225536221094258. doi: 10.1177/10225536221094258.
To evaluate the clinical efficacy of using free tissue flap combined with contralateral instep thick plantar skin in reconstructing complex plantar forefoot defects.
During the past 8 years, 15 patients, aged 25-60 years, with defects in the soft-tissue and composite bone of the forefoot were treated. Their defects were caused by trauma. These defects were all located on the plantar forefoot. The free tissue flaps transposed to reconstruct defects were anterolateral thigh flaps, groin flaps, and latissimus dorsi flaps. Flap size varied in width 4-cm and length (6-16 cm). The mean size of flaps was 80.3 cm. The follow-up period ranged from 12 to 90 months (mean, 25.5 months).
Partial flap loss was observed in one anterolateral thigh flap and one latissimus dorsi flap. One patient showed skin graft loss at the defect site, and the wound was re-epithelialized by changing dressings. Hyperkeratosis was not observed in any of the cases. All patients were able to walk near-normally within 2.5 months after surgery, and there was no recurrence of ulceration.
We advocate using a free tissue flap combined with contralateral instep thick plantar skin for reconstruction of moderate or large complex plantar forefoot defects.
评估游离组织瓣联合对侧足背厚皮瓣重建复杂前足跖部缺损的临床疗效。
8 年来，我们治疗了 15 例年龄 25-60 岁的前足软组织和复合骨缺损患者。这些缺损是由创伤引起的，均位于前足跖部。用于重建缺损的游离组织瓣为股前外侧皮瓣、腹股沟皮瓣和背阔肌皮瓣。皮瓣的宽度为 4cm，长度（6-16cm）。皮瓣的平均大小为 80.3cm。随访时间为 12-90 个月（平均 25.5 个月）。
1 例股前外侧皮瓣和 1 例背阔肌皮瓣出现部分皮瓣坏死。1 例患者缺损处皮肤移植失败，通过换药使创面重新上皮化。所有患者均未出现过度角化。所有患者术后 2.5 个月内均可基本正常行走，无溃疡复发。
我们主张使用游离组织瓣联合对侧足背厚皮瓣重建中、大型复杂前足跖部缺损。
