[Simultaneous autologous spongioplasty and muscle flap transposition to restore the continuity of the leg with an osteitis defect]

Abstract

About 12% of compound fractures of the lower leg give rise to posttraumatic osteitis. Loss of bone by sequestration causes many problems particularly if soft tissue quality is poor. Cancellous and corticocancellous bone from the iliac crest is used for bony reconstruction. To obtain bony union, a well vascularised recipient for the graft is essential. Local muscle flaps and distant microvascular flaps and distant microvascular flaps improve vascularity by their separate connection to the vascular system. We treated 54 soft tissue defects by local muscle flaps in 41 and by microvascular flaps in 13 cases. In 21 cases a cancellous or a corticocancellous bone graft was used. Necrosis or partial necrosis of the flap occurred in 12 cases. Skin closure and healing was obtained by secondary procedures. Combined muscle flap and bone grafting was found to allow full weight bearing within reasonable period of time.