Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205 Geneva, Switzerland; Department of Surgery, HFR Fribourg Cantonal Hospital, 1708 Fribourg, Switzerland.
Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205 Geneva, Switzerland.
J Plast Reconstr Aesthet Surg. 2024 Aug;95:207-215. doi: 10.1016/j.bjps.2024.06.014. Epub 2024 Jun 12.
Managing wounds of the lateral malleolus is challenging owing to limited nearby tissues and possibly injured or inadequate vessels for free flaps, especially in case of underlying infections. Moreover, free flaps require specialized skills and are not suitable for every patient. Therefore, identifying reliable local alternatives is crucial. This retrospective study investigated the efficacy and safety of the distally based peroneus brevis muscle flap in treating complex and infected soft-tissue defects of the lateral malleolus.
A retrospective medical chart review of all patients who underwent a distally based peroneus brevis muscle flap reconstruction in the context of an infected lateral malleolus defect at Geneva University Hospitals between October 2020 and January 2024 was performed.
Ten patients underwent lateral malleolus reconstruction using a distally based peroneus brevis muscle flap primarily to address post-traumatic infections. Flap coverage was performed within 4 weeks of infection onset for post-traumatic cases, alongside antibiotic treatment. The defects were moderate in size, with a median width of 2.5 cm and length of 5.5 cm. There were no complete or partial flap failures. All patients regained the ability to walk within 5 days after surgery.
The distally based peroneus brevis muscle flap was efficient in managing complex and infected soft-tissue defects of the lateral malleolus, with control of infection in all patients and minimal donor-site morbidity.
由于附近组织有限，以及游离皮瓣可能受损或血管不足，尤其是在存在感染的情况下，处理外踝的伤口具有挑战性。此外，游离皮瓣需要专业技能，并不适合每个患者。因此，确定可靠的局部替代方案至关重要。本回顾性研究调查了腓骨短肌远端蒂皮瓣在外踝复杂和感染性软组织缺损中的治疗效果和安全性。
对 2020 年 10 月至 2024 年 1 月期间在日内瓦大学医院因感染性外踝缺损接受腓骨短肌远端蒂皮瓣重建的所有患者进行了回顾性病历审查。
10 例患者因创伤后感染，采用腓骨短肌远端蒂皮瓣进行外踝重建。对于创伤后病例，在感染发病后 4 周内进行皮瓣覆盖，并联合抗生素治疗。缺损中等大小，宽度中位数为 2.5cm，长度为 5.5cm。无完全或部分皮瓣失败。所有患者在手术后 5 天内均恢复行走能力。
腓骨短肌远端蒂皮瓣在外踝复杂和感染性软组织缺损的处理中效果显著，所有患者均控制了感染，且供区并发症轻微。
