Abstract
Background: We presents the axial and via perforator vascularised flaps for covering lower limb posttraumatic, septic and diabetic necrosis.
Methods and patients: During the past 4 years we operated 23 patients, 20 males and 3 females with posttraumatic or septic lower limb necrosis: two of the external maleolar area, 6 of the dorsal foot, three of the Achilles tendon area, 2 anterior lower tibia, 4 of the calcaneal area. Osteomyelitis was present in 6 cases (tibia, metatarsals, calcaneus)
All traumatic cases happened almost 2 weeks before operation except three which caused between 2 and 6 months earlier. In the 2 diabetic cases the lesion appeared between 3 and 5 month ago.
We have performed: 9 sural flaps, 5 perforator-posterior tibial artery flap, 1 medial plantar, 4 based on distal perforators of the peroneal artery, 1 Saphenous, 2 muscular flaps.
All patients were between 17 and 81 years all and the follow up between 8 month and 2 years. Everywhere before the flap we performed surgical debridement.
As supplementary combined reconstructive technique we performed: 1. Mega papineau technique, 2. Bone filling, 3. Distraction osteogennesis, with spatial Taylor frame.
Results: We covered successfully the defects, with satisfactory aesthetical results, while the functional ability was not compromised.
Results: The above flaps have been proved effective for covering the lower limb defects.
These flaps are better tolerated by the patient than the traditional techniques and safer, less demanding and faster to perform than the free tissue transfers.
Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org
