The Effect of Ilizarov Bone Distraction on the Transferred Free Flap in the Reconstructed Leg

ABSTRACT

For the reconstruction of the bone and soft tissue defect in the leg, combined free muscle flap and Ilizarov bone distraction method have been described as useful treatment modality. Five patients were treated by delayed Ilizarov method in conjunction with free muscle flap coverage. All flaps survived in spite of distraction of bone, elevation of flap for docking procedure and partial flap revision. There were no anastomotic complications. Tendency of decreased flap dimension and interposition of flap between distracted bone stumps were noted. The mean segmental defects were 8.8 cm and the mean distraction lengths were 9.8cm. The mean periods from free muscle flap coverage to Ilizarov bone distraction were 77 days(the shortest periods were 19 days and the longest periods were 5 months). The follow up interval from the time of free muscle flap coverage ranged from 4 to 35 months. Gradual distraction of a free tissue is a safe procedure and does not compromise the vascular flow to the flap. The position of flap and vascular pedicle should be carefully planned and the onset and the rate of distraction should be individualized.