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. 2021 Feb 1;86(2S Suppl 1):S91-S95.
doi: 10.1097/SAP.0000000000002625.

Reconstruction of Tibia Fracture With Soft Tissue Defect

Po-Lun Tsai  1 , Otto R Ziegler, Rowena Sudario-Lumague, Tsan-Shiun Lin
Affiliations

Reconstruction of Tibia Fracture With Soft Tissue Defect

Po-Lun Tsai et al. Ann Plast Surg. .

Abstract

Background: We aimed to compare different methods to treat lower leg soft tissue defects with tibia fracture using free flaps and pedicled flaps. We also highlighted the aesthetic outcome after using 1-stage secondary debulking procedure for tibia area.

Patients and methods: From December 2000 to March 2017, 83 patients with lower leg defects and tibia fractures were reconstructed using 71 free flaps and 12 pedicled flaps. One-stage secondary debulking procedures were performed for 39 patients after flap reconstruction. Infection control and aesthetic outcomes using 5-point Likert scale were reviewed after a 16-month follow-up.

Results: Twenty-five myocutaneous free flaps, 45 fasciocutaneous free flaps, 1 fibula free flap, 12 pedicled flaps of which 8 were distally based sural artery flaps, and 4 medial gastrocnemius flaps were used. The flap survival rate was 100%. There was no recurrence of osteomyelitis in any patient after reconstruction with any of these flaps. Using a 5-point Likert scale, performance of a 1-stage secondary debulking procedure showed statistically significant difference in terms of contour, color, and texture compared with the group without debulking procedure.

Conclusions: The use of free flaps and pedicled flaps in the reconstruction of lower leg defects with tibia fracture is reliable and results in good infection control. A 1-stage secondary debulking procedure delivers excellent long-term aesthetic outcome after reconstruction of the tibia area.

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Conflict of interest statement

Conflicts of interest and sources of funding: none declared.

References

    1. Lachica RD. Evidence-based medicine: management of acute lower extremity trauma. Plast Reconstr Surg . 2017;139:287e–301e.
    1. Zhu Y, Liu S, Zhang X, et al. Incidence and risks for surgical site infection after adult tibial plateau fractures treated by ORIF: a prospective multicentre study. Int Wound J . 2017;14:982–988.
    1. Almeida Matos M, Castro-Filho RN, Pinto da Silva BV. Risk factors associated with infection in tibial open fractures. Rev Fac Cien Med Univ Nac Cordoba . 2013;70:14–18.
    1. Larsen P, Elsoe R, Hansen SH, et al. Incidence and epidemiology of tibial shaft fractures. Injury . 2015;46:746–750.
    1. Levin LS. The reconstructive ladder. An orthoplastic approach. Orthop Clin North Am . 1993;24:393–409.

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