N Tajsiç1, R Winkel, R Hoffmann, H Husum. 1. Department of Surgery, Institute of Clinical Medicine, University of Tromso, PO Box 80, University Hospital North Norway, Norway.
Abstract
BACKGROUND: The treatment of post-traumatic osteomyelitis of the lower leg and the foot remains a challenge in reconstructive surgery. MATERIAL AND METHODS: Eighty-six patients with lower leg post-injury chronic osteomyelitis were included in a retrospective, non-controlled clinical study conducted from 1995 to 2006. All study patients were managed by distally based sural neuro-fascio-cutaneous perforator flap. An endpoint survey was conducted after flap surgery and had a mean follow-up period of 5.5 years, wherein the response rate was 48%. RESULTS: Seven patients had a short-term flap failure (8%; 95% CI 3-16%). An additional eight patients (7%) had flap necrosis of less than one-fourth of the flap that healed without surgical revision. Based on the endpoint data, the long-term success rate was 87% (95%, CI 72-96%). Local and/or systemic physiological compromise was a risk factor for flap failure. Other assumed risk factors had no statistically significant impact on short- or long-term results. CONCLUSION: Sural perforator flap is a robust flap with low failure rate, even in high-risk patients. The success rate compares favourably with results of free flap transfers in the management of post-traumatic osteomyelitis. The flap has a wide range, and the surgical technique is rather simple. The sural flap is a feasible option for post-traumatic reconstructions of osteomyelitis, especially in low-resource settings.
BACKGROUND: The treatment of post-traumatic osteomyelitis of the lower leg and the foot remains a challenge in reconstructive surgery. MATERIAL AND METHODS: Eighty-six patients with lower leg post-injury chronic osteomyelitis were included in a retrospective, non-controlled clinical study conducted from 1995 to 2006. All study patients were managed by distally based sural neuro-fascio-cutaneous perforator flap. An endpoint survey was conducted after flap surgery and had a mean follow-up period of 5.5 years, wherein the response rate was 48%. RESULTS: Seven patients had a short-term flap failure (8%; 95% CI 3-16%). An additional eight patients (7%) had flap necrosis of less than one-fourth of the flap that healed without surgical revision. Based on the endpoint data, the long-term success rate was 87% (95%, CI 72-96%). Local and/or systemic physiological compromise was a risk factor for flap failure. Other assumed risk factors had no statistically significant impact on short- or long-term results. CONCLUSION: Sural perforator flap is a robust flap with low failure rate, even in high-risk patients. The success rate compares favourably with results of free flap transfers in the management of post-traumatic osteomyelitis. The flap has a wide range, and the surgical technique is rather simple. The sural flap is a feasible option for post-traumatic reconstructions of osteomyelitis, especially in low-resource settings.
Authors: H Bezstarosti; E M M Van Lieshout; L W Voskamp; K Kortram; W Obremskey; M A McNally; W J Metsemakers; M H J Verhofstad Journal: Arch Orthop Trauma Surg Date: 2018-10-20 Impact factor: 3.067
Authors: Jun Hyeok Kim; Chae Rim Lee; Hyo Jeong Kwon; Deuk Young Oh; Young-Joon Jun; Jong Won Rhie; Suk-Ho Moon Journal: Medicine (Baltimore) Date: 2022-07-29 Impact factor: 1.817