Distally based sural fasciomusculocutaneous flap for treatment of wounds of the distal third of the leg and ankle with exposed internal hardware

Luca Vaienti, Adriano Di Matteo, Riccardo Gazzola, Pietro Randelli, Jlenia Lonigro

Research output: Contribution to journalArticle

Abstract

Soft tissue reconstruction of the distal third of the lower limb with exposure of the internal hardware is a challenging problem with several potential complications, such as exposure of the fracture line, fracture instability and bacterial contamination. The treatment of these lesions usually consists of substitution of the internal hardware with external fixation devices and further flap coverage. We propose a different reconstructive approach, characterized by harvesting a sural fasciomusculocutaneous flap on the exposed internal hardware once a sterile ground has been obtained. Four patients were retrospectively analyzed. Soft tissue reconstruction was achieved in all cases. In one case hardware removal was necessary for complete healing. The sural fasciomusculocutaneous flap is a safe alternative to other pedicled and free flaps. Moreover, it allows direct coverage of internal fixators, thus completing the reconstruction in less time. This flap fits best to the morphology of the wound and internal hardware, leaving the main vascular trunk of the leg intact and at the same time providing a reliable vascular supply.

Original languageEnglish
Pages (from-to)35-39
Number of pages5
JournalJournal of Orthopaedics and Traumatology
Volume13
Issue number1
DOIs
Publication statusPublished - Mar 2012

Keywords

  • Exposure
  • Fasciomusculocutaneous sural flap
  • Infection
  • Internal hardware
  • Lower limb

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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