Medial leg flap containing posterior tibial vessels for reconstructio n in children's limb injuries by high-energy / 中国矫形外科杂志

ABSTRACT

[Objective]To report the clinical results of free medical leg flap containing posterior tibial vessels (FMLFPTV) in repairing of serious limb trauma caused by high-energy in children and discuss the flap's unique superiorities.[Method]From Jan.1999 to Mar.2006,FMLFPTV were obtained under tourniquet and applied in ten children suffered from serious limb and extremity injuries complicated by soft tissue defects,meanwhile,vessels and nerves were repaired with the flaps' corresponding tissues,moreover,broken bones and tendons were reconstructed.[Result]Average blood loss was 183ml and mean operative time was 208 min.All flaps were transplanted successfully with excellent results including satisfactory limb appearance.Follow-up ranged 14 to 67 months (averaged 35 months).Sensation has recovered to more than S3 in all cases.In those who were treated with this innervated flap to repair defects of weight-bearing area of sole,no sore or ulcer occurred and normal gait recovered.Bone union took 4～9 months(averaged 6.7 months).Through investigation forms filled by parents and clinical examination,no blood supply problem or morbidity was discovered in donor limbs.[Conclusion]FMLFPTV is easy to dissect under tourniquets with relative short operative time and less blood lost which especially benefits children.The flap is thin and has almost necessary related tissues for all reconstructive needs,for example,to bridge vessel and nerve defects,and offer excellent results.It is an easy and reliable method.