Z Hou1, Z Xu, Z Su. 1. Department of Orthopedic Surgery, First People's Hospital, Guangzhou 510180, China.
Abstract
OBJECTIVE: To sum up experiences and lessons ab out management of soft-tissue reconstruction in open tibial fracture over a 6-year period. METHODS: Twenty-two flap reconstructions were performed to tre at soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively aft er follow up of 12-61 months. RESULTS: The size of the flap ranged from 6.6 cm(2) to 28.18 cm(2) and the rate of flap failure was 13.6%. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series. CONCLUSIONS: For soft tissue defect of delayed open tibial fracture Type IIIB, flap reconstruction is still an optimal option. The experiences we obtained are 1) to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; 2) to select a unilateral external fixation to provide convenience for any secondary manipulation; and 3) to use serial debridement to diminish flap failure.
OBJECTIVE: To sum up experiences and lessons ab out management of soft-tissue reconstruction in open tibial fracture over a 6-year period. METHODS: Twenty-two flap reconstructions were performed to tre at soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively aft er follow up of 12-61 months. RESULTS: The size of the flap ranged from 6.6 cm(2) to 28.18 cm(2) and the rate of flap failure was 13.6%. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series. CONCLUSIONS: For soft tissue defect of delayed open tibial fracture Type IIIB, flap reconstruction is still an optimal option. The experiences we obtained are 1) to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; 2) to select a unilateral external fixation to provide convenience for any secondary manipulation; and 3) to use serial debridement to diminish flap failure.