Thigh Perforator Free Flap for Reconstruction of the Soft Tissue Defect of the Lower Extremity / 대한족부족관절학회지

INTRODUCTION: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. MATERIALS AND METHODS: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from 4 x 5 cm to 12 x 18 cm. The mean flap area was 73.2 cm2. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. RESULTS: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. CONCLUSION: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.

Subtrochanteric Fracture after Cannulatd Screw Fixation of Femoral Neck Fracture in a Child: A Case Report

Though femoral neck fractures in adults are usually treated by fixation with multiple screws, subtrochanteric fracture at the insertion site is an uncommon complication, and in children, there has been a few reports about this complication after treatment of slipped capital femoral epiphysis. We report a subtrochanteric fracture at the insertion site of cannulated screws used in femoral neck fracture of a 9-years old boy.