Laitonjam Michael, Khan Manal M, Krishna Deepak, Cheruvu Ved Prakash Rao, Minz Reena
Plastic and Reconstructive Surgery, Shija Hospital and Research Institute, Imphal, IND.
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Cureus. 2023 Jun 25;15(6):e40946. doi: 10.7759/cureus.40946. eCollection 2023 Jun.
Reconstruction of foot and ankle defects requires selecting an appropriate durable and aesthetically appealing option. From the different options, the procedure's choice depends on the defect's size, location, and donor area's availability. Patients' main goal is to have an acceptable biomechanical outcome.
In this prospective study, we have included patients who had undergone reconstruction of the ankle and foot defects between January 2019 and June 2021. Patient demographics, location and size of the defect, different procedures, complications, sensory recovery, ankle hindfoot score, and satisfaction score were recorded.
50 patients with foot and ankle defects were enrolled in this study. All flaps survived except one free anterolateral thigh flap. Five locoregional flaps developed minor complications, and all skin grafts healed well. The Ankle Hindfoot Score outcome has no significant relation with the anatomical location of the defects and the reconstructive procedure. All patients reconstructed using random local flap and with free flap were satisfied with the aesthetic outcome.
Because of limited soft tissue, local flap availability is restricted to small defects. Satisfaction rates are high in local and free flaps and are best suited for reconstructing the weight-bearing part of the foot. Bulky flaps should be avoided over the dorsum and ankle region.
足踝部缺损的重建需要选择一种合适的、耐用且美观的方法。在不同的选择中，手术方式的选择取决于缺损的大小、位置以及供区的可用性。患者的主要目标是获得可接受的生物力学结果。
在这项前瞻性研究中，我们纳入了2019年1月至2021年6月期间接受足踝部缺损重建的患者。记录患者的人口统计学资料、缺损的位置和大小、不同的手术方式、并发症、感觉恢复情况、踝后足评分和满意度评分。
本研究纳入了50例足踝部缺损患者。除1例游离股前外侧皮瓣外，所有皮瓣均存活。5例局部皮瓣出现轻微并发症，所有植皮均愈合良好。踝后足评分结果与缺损的解剖位置和重建手术无显著相关性。所有采用随意局部皮瓣和游离皮瓣重建的患者对美学效果均满意。
由于软组织有限，局部皮瓣的应用仅限于小缺损。局部皮瓣和游离皮瓣的满意度较高，最适合重建足部的负重部位。应避免在足背和踝部区域使用体积较大的皮瓣。
