The treatment of open fracture and infection of tibia by grafting the musculocutaneous flap with uncovered in the special region / 中华显微外科杂志

ABSTRACT

Objective To study the clinical value of grafting the musculocutaneous flap with uncovered in the special region to treat the open fracture and infection of tibia. Methods Twenty-eight patients including 19 males and 9 females with ankle and leg tissue defect were applied to graft the musculocutaneous flap with uncovered in the special region from July 2007 to January 2010. The tissue defeat in proximal part of the tibia were 6 cases, and 21 cases in middle and distal part, 1 case almost in whole part of the tibia. The bone occurred a defeat and infection in 23 cases, the bone necrosis occurred in 5 cases. The patients treated with iliac bone flap were 5 cases, anterolateral thigh flap were 21 cases, anterolateral thigh flap combined with fibula flap were 2 cases, the flap were transplanted by anastomosis in 26 cases. Results The tissue grafting were all survival and the survival rate were 100%. The callus formation were appear after operation from 3 to 6 months, and necrosis bone tissue almost were abstracted about 6 months. The wound were primary closure and not happened infection in 26 cases, the wound appeared infection under deep tissue in 2 cased,but being cured after 6 months by operation. The 21 patients were followed up from 3 months to one and helf year. The long-term was satisfaction and the donor area was perfect. Compared with closed graft, its area of the flap was small and need spend little time to treat the repair the defeat, and harness to recover the healthy of body and mind, also decrease the chance of infection in deep tissue. Conclusion It is demonstrated that grafting the tissue flap with uncovered in the special region is an ideal approach to treat the open fracture and infection of tibia.