ILIAC FLAP COMBINED WITH ANTEROLATERAL THIGH FLAP FOR REPAIR OF FIRST METATARSAL BONE AND LARGE SKIN DEFECT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GUOJia ¹ ,  LIUYong ² , LIUXiaohui ² , SUIZhiqiang ² , ZHANGXuetao ² , WANGLei ²

1. Department of Surgery, Weifang Medical University, Weifang Shandong, 261053, P.R.China;
2. Institute of Orthopaedics, the 89th Hospital of Chinese PLA;

Corresponding?author：

LIUYong, Email: 13793694402@163.com

Keywords：

Iliac flap; Anterolateral thigh flap; The first metatarsal bone; Soft tissue defect; Wound repair

DOI：

10.7507/1002-1892.20160288

Video：

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Objective To investigate the surgical methods and effectiveness to use the iliac flap combined with anterolateral thigh flap for repair of the first metatarsal bone and large skin defect. Methods Between January 2013 and January 2016, iliac flap combined with anterolateral thigh flap was used to repair the first metatarsal bone and large skin defect in 9 patients. There were 5 males and 4 females, with a median age of 15 years (range, 10 to 60 years). The causes included traffic accident injury in 6 cases and crush injury of machine in 3 cases. The average time from injury to operation was 3 hours to 14 days (mean, 7 days). The size of skin soft tissue defect ranged from 10 cm×6 cm to 20 cm×10 cm. The size of first metatarsal bone defect ranged from 2 cm×1 cm to 5 cm×1 cm. The size of iliac flap was 3.0 cm×1.5 cm to 6.0 cm×1.5 cm, and the size of anterolateral thigh flap was 10 cm×6 cm to 20 cm×10 cm. The donor site was directly sutured or repaired by free skin graft. Results After operation, the composite flaps survived with primary healing of wound; the skin grafts at donor site survived and the incision healed by first intention. All patients were followed up 6 months to 2 years (mean, 1.6 years). X-ray examination showed that the bone healing time was 3.5-5.0 months (mean, 4 months). The flap had soft texture, good color and appearance. All patients could normally walk. According to the American Orthopaedic Foot and Ankle Society (AOFAS) standard, the foot function was excellent in 6 cases and good in 3 cases, and the excellent and good rate was 100% at last follow-up. Conclusion The iliac flap combined with anterolateral thigh flap for repair of the first metatarsal bone and large skin defect is a practical way with good shape at one stage.

Citation： GUOJia, LIUYong, LIUXiaohui, SUIZhiqiang, ZHANGXuetao, WANGLei. ILIAC FLAP COMBINED WITH ANTEROLATERAL THIGH FLAP FOR REPAIR OF FIRST METATARSAL BONE AND LARGE SKIN DEFECT. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(11): 1400-1403. doi: 10.7507/1002-1892.20160288 Copy

1.	Maskill JD, Bohay DR, Anderson JG. Gastrocnemius recession to treat isolated foot pain. Foot Ankle Int, 2010, 31(1): 19-23.
2.	王成琪.皮瓣和肌皮瓣修復創傷性組織缺損的作用.中華顯微外科雜志, 1999, 22(1): 11-12.
3.	吳攀峰, 唐舉玉, 李康華, 等.旋髂深動脈嵌合穿支皮瓣修復四肢骨和軟組織缺損.中華顯微外科雜志, 2014, 37(6): 524-527.
4.	申屠剛, 王剛, 李強, 等.吻合血管的髂骨瓣移植修復四肢骨缺損22例.中華顯微外科雜志, 2015, 38(2):173-175.
5.	劉勇, 張成進, 付興茂, 等.跨供區髂骨皮瓣一期修復肢體大面積骨與軟組織缺損.中華骨科雜志, 2009, 29(7): 662-666.
6.	Yazar S, Lin CH, Wei FC. One-stage reconstruction of composite bone and soft tissue defects in traumatic lower extremities. Plast Reconstr Surg, 2004, 114(6): 1457-1466.
7.	張斌, 黃富國, 楊志明.吻合血管骨瓣移植修復骨折不愈合或大塊骨組織缺損.中國修復重建外科雜志, 2002, 16(3): 185-187.
8.	許亞軍, 芮永軍, 孫振中, 等.游離髂腹部(髂骨)皮瓣的血管分型.實用手外科雜志, 2015, 29(2): 123-125, 190.
9.	孫賀, 徐達傳, 杜心如, 等.旋髂深血管蒂髂骨瓣轉位腰骶椎植骨的應用解剖.中國臨床解剖學雜志, 2004, 22(1): 60-62.
10.	Zahid M, Bin Sabir A, Asif N, et al. Fixation using cannulated screws and fibular strut grafts for fresh femoral neck fractures with posterior comminution. J Orthop Surg (Hong Kong), 2012, 20(2): 191-195.
11.	朱躍良, 梅良斌, 呂乾, 等.足踝軟組織重建的皮瓣選擇策略: 14種皮瓣226例分析.中華顯微外科雜志, 2014, 37(3): 242-245.
12.	劉會仁, 劉家寅, 張艷茂, 等.股前外側穿支皮瓣的臨床應用與分型.中華顯微外科雜志, 2016, 39(2): 119-122.
13.	隋海明, 叢海波, 翟建國, 等.大面積股前外側皮瓣的設計與切取:附28例報告.中華顯微外科雜志, 2014, 37(2): 143-146.
14.	譚屏, 湯玉泉, 曾凱生, 等.游離股前外側穿支皮瓣修復大面積皮膚軟組織缺損的臨床研究.中國骨與關節損傷雜志, 2014, 29(6): 100-101.
15.	Goldie S, Thompson R, Soutar DS, et al. Arterial supply of the deep circumflex iliac artery (DCIA) flap. Eur J Plast Surg, 2008, 31(6): 311-314.
16.	李濤, 陳振兵, 叢曉斌, 等.吻合淺靜脈的穿支螺旋槳皮瓣的臨床應用.中華整形外科雜志, 2015, 31(2): 107-110.
17.	傅尚俊, 楊曉東, 楊錦, 等.游離股前外皮瓣移植術后靜脈危象的病因探討.中華手外科雜志, 2015, 31(4): 313-314.
18.	Innocenti M, Menichini G, Baldrighi C, et al. Are there risk factors for complications of perforator-based propeller flaps for lower-extremity reconstruction? Clin Orthop Relat Res, 2014, 472(7): 2276-2286.

1. Maskill JD, Bohay DR, Anderson JG. Gastrocnemius recession to treat isolated foot pain. Foot Ankle Int, 2010, 31(1): 19-23.
2. 王成琪.皮瓣和肌皮瓣修復創傷性組織缺損的作用.中華顯微外科雜志, 1999, 22(1): 11-12.
3. 吳攀峰, 唐舉玉, 李康華, 等.旋髂深動脈嵌合穿支皮瓣修復四肢骨和軟組織缺損.中華顯微外科雜志, 2014, 37(6): 524-527.
4. 申屠剛, 王剛, 李強, 等.吻合血管的髂骨瓣移植修復四肢骨缺損22例.中華顯微外科雜志, 2015, 38(2):173-175.
5. 劉勇, 張成進, 付興茂, 等.跨供區髂骨皮瓣一期修復肢體大面積骨與軟組織缺損.中華骨科雜志, 2009, 29(7): 662-666.
6. Yazar S, Lin CH, Wei FC. One-stage reconstruction of composite bone and soft tissue defects in traumatic lower extremities. Plast Reconstr Surg, 2004, 114(6): 1457-1466.
7. 張斌, 黃富國, 楊志明.吻合血管骨瓣移植修復骨折不愈合或大塊骨組織缺損.中國修復重建外科雜志, 2002, 16(3): 185-187.
8. 許亞軍, 芮永軍, 孫振中, 等.游離髂腹部(髂骨)皮瓣的血管分型.實用手外科雜志, 2015, 29(2): 123-125, 190.
9. 孫賀, 徐達傳, 杜心如, 等.旋髂深血管蒂髂骨瓣轉位腰骶椎植骨的應用解剖.中國臨床解剖學雜志, 2004, 22(1): 60-62.
10. Zahid M, Bin Sabir A, Asif N, et al. Fixation using cannulated screws and fibular strut grafts for fresh femoral neck fractures with posterior comminution. J Orthop Surg (Hong Kong), 2012, 20(2): 191-195.
11. 朱躍良, 梅良斌, 呂乾, 等.足踝軟組織重建的皮瓣選擇策略: 14種皮瓣226例分析.中華顯微外科雜志, 2014, 37(3): 242-245.
12. 劉會仁, 劉家寅, 張艷茂, 等.股前外側穿支皮瓣的臨床應用與分型.中華顯微外科雜志, 2016, 39(2): 119-122.
13. 隋海明, 叢海波, 翟建國, 等.大面積股前外側皮瓣的設計與切取:附28例報告.中華顯微外科雜志, 2014, 37(2): 143-146.
14. 譚屏, 湯玉泉, 曾凱生, 等.游離股前外側穿支皮瓣修復大面積皮膚軟組織缺損的臨床研究.中國骨與關節損傷雜志, 2014, 29(6): 100-101.
15. Goldie S, Thompson R, Soutar DS, et al. Arterial supply of the deep circumflex iliac artery (DCIA) flap. Eur J Plast Surg, 2008, 31(6): 311-314.
16. 李濤, 陳振兵, 叢曉斌, 等.吻合淺靜脈的穿支螺旋槳皮瓣的臨床應用.中華整形外科雜志, 2015, 31(2): 107-110.
17. 傅尚俊, 楊曉東, 楊錦, 等.游離股前外皮瓣移植術后靜脈危象的病因探討.中華手外科雜志, 2015, 31(4): 313-314.
18. Innocenti M, Menichini G, Baldrighi C, et al. Are there risk factors for complications of perforator-based propeller flaps for lower-extremity reconstruction? Clin Orthop Relat Res, 2014, 472(7): 2276-2286.

Chinese Journal of Reparative and Reconstructive Surgery

ILIAC FLAP COMBINED WITH ANTEROLATERAL THIGH FLAP FOR REPAIR OF FIRST METATARSAL BONE AND LARGE SKIN DEFECT

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