Reconstruction of complex lesions of the third distal of the leg and foot has always been one of the most arduous. The algorithm for selecting the flap is often difficult and depends on many factors. In recent years, inverted circle island flaps in particular have been added to the wide array of available solutions. Loco-regional flaps are restricted by their dimensions, whereas free flaps may be adapted to suit the requirements of each individual case, thereby optimizing treatment. In this paper we present a review of our case material in order to rationalize indications and highlight advantages and limits to use of this type of flap. Over the period 1992-1997, we treated 15 cases with a free parascapular flap to cover osteo-tendinous exposures of the foot and Achilles region, one case of neurofibroma of the foot, 5 adherent and dystrophic scars, 2 cases of osteomyelitis and osteitis of the leg and one case of sequelae of Volkmann's syndrome of the leg. Use of the parascapular flap in the treatment of complex distal lesions of the lower extremity produced satisfactory outcome in 93.3% of cases. Choice of this flap was dictated by several factors: the quality of the cutis and thickness of the subcutaneous tissue are suitable for reconstruction of this region, anatomy is constant, the blood vessels are the right size for anastomosis, and the operation may be performed by two surgical teams, thereby reducing the lenght of intervention time. Moreover the fact that an osseous segment vascularized by an autonomous branch may be included extends the range of possible applications of this flap and also permits reconstruction of small bone tissue loss.
|Translated title of the contribution||The free parascapular flap in traumatisms of the lower extremity|
|Number of pages||6|
|Journal||Rivista Italiana di Chirurgia Plastica|
|Publication status||Published - 1999|
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