Goud Raja Kiran Kumar, Lakshmi Palukuri, Pawde Sanujit, Dharmapuri Madhulika, Sankar Swati, Chintha Sandeep Reddy
Department of Plastic Surgery, Osmania General Hospital, Osmania Medical College, Hyderabad, India.
J Trauma Inj. 2023 Sep;36(3):217-223. doi: 10.20408/jti.2023.0005. Epub 2023 Sep 18.
Defects involving the ankle and foot are often the result of road traffic accidents. Many such defects are composite and require a flap for coverage, which is a significant challenge for reconstructive surgeons. Various locoregional options, such as reverse sural artery, reverse peroneal artery, peroneus brevis muscle, perforator-based, and fasciocutaneous flaps, have been used, but each flap type has limitations. In this study, we used the distally based lateral supramalleolar flap to reconstruct distal dorsal defects of the foot. The aim of this study was to analyze the efficacy of the flap in reconstructing distal dorsal defects of the foot. The specific objectives were to study the adequacy, reach, and utility of the lateral supramalleolar flap for distal defects of the dorsum of the foot; to observe various complications encountered with the flap; and to study the functional outcomes of reconstruction.
The distal dorsal foot defects of 10 patients were reconstructed with distal lateral supramalleolar flaps over a period of 6 months at a tertiary care center, and the results were analyzed.
We were able to effectively cover distal foot defects in all 10 cases. Flap congestion was observed in two cases, and minor graft loss was seen in two cases.
The distally based lateral supramalleolar flap is a good pedicled locoregional flap for the coverage of distal dorsal foot and ankle defects of moderate size, with relatively few complications and little morbidity. It can be used as a lifeboat or even substitute for a free flap.
涉及踝关节和足部的缺损通常是道路交通事故的结果。许多此类缺损是复合性的，需要皮瓣覆盖，这对重建外科医生来说是一项重大挑战。已经使用了各种局部区域皮瓣选择，如腓肠神经营养血管逆行岛状皮瓣、腓动脉逆行岛状皮瓣、短伸肌肌瓣、穿支皮瓣和筋膜皮瓣，但每种皮瓣类型都有局限性。在本研究中，我们使用远端蒂外踝上外侧皮瓣修复足部远端背侧缺损。本研究的目的是分析该皮瓣修复足部远端背侧缺损的疗效。具体目标是研究外踝上外侧皮瓣修复足部远端背侧缺损的充分性、覆盖范围和实用性；观察该皮瓣出现的各种并发症；以及研究重建后的功能结果。
在一家三级医疗中心，在6个月的时间里，使用远端蒂外踝上外侧皮瓣修复了10例患者的足部远端背侧缺损，并对结果进行了分析。
我们成功地在所有10例病例中有效覆盖了足部远端缺损。2例出现皮瓣充血，2例出现轻微植皮丢失。
远端蒂外踝上外侧皮瓣是一种良好的带蒂局部区域皮瓣，可用于覆盖足部远端背侧和踝关节中等大小的缺损，并发症相对较少，发病率较低。它可作为一种“救生艇”皮瓣，甚至可替代游离皮瓣。
