Muscle Free Flap Transplantation in Chronic Osteomyelitis of the Lower Extremities

ABSTRACT

PURPOSE: To evaluate the result of muscle free flap transplantation in chronic osteomyelitis of the tibia and calcaneus occurred from open fractures and exposed bones and internal fixatives. MATERIALS AND METHODS: The free muscle flap were transferred in the tibia and calcaneus and followed up average 7.3 years at the department of orthopedic surgery from March 1997 to September 2009. Six patients were male and 1 case female averaged 50.3 years of age. Two latissimus dorsi myocutaneous free flaps were transplanted to the exposed 2/3 of the tibia with soft tissue defect, one rectus abdominis muscle free flap to the mid 1/3 of the tibia and four gracilis muscle free flaps to the distal 1/3 of the tibia and calcaneus. RESULTS: At average 7.2 years follow-up, all of the 7 cases obtained solid bone union in the X-ray and kept sound soft tissues without pus discharges. The overall result of bone union, healed soft tissues defect and normal knee and ankle joint range of motion were excellent. CONCLUSION: The free muscle flap transferred to the chronic osteomyelitis of the tibia and calcaneus showed excellent results in bone union and eradication of the pus forming bacteria by its abundant blood flow.