Skin coverage of exposed tibial fracture with an antegrade flow sural flap
Keywords:
surgical flaps, fractures, surgery, orthopedic procedures, methods.Abstract
Introduction: The loss of skin coverage of the limbs represents a therapeutic dilemma for the orthopedic surgeon. The choice of the reconstruction technique in the lower extremities depends on the morbidity caused by the trauma. Numerous local flaps and many other procedures have been described to achieve adequate coverage of these segments.
Objective: To present the antegrade flow sural flap as a therapeutic alternative for the adequate coverage of complex defects of the upper third of the tibia and knee.
Case report: We report a 28-year-old female patient who, after suffering a traffic accident, presented an open comminuted fracture of the upper third of the right tibia, a flap wound with loss of skin and exposure of the fracture site. After placing the RALCA external fixator, an antegrade flow island sural flap was performed to cover the bone and the patellar tendon. In addition, partial skin grafting was used in the surrounding area and the donor site on the posterior face.
Conclusions: The antegrade flow sural flap is successful in the treatment of large soft tissue defects in the knee and upper third of the tibia. It is considered a reliable, durable and easy-to-perform procedure, with no significant morbidity in the donor area. It constitutes an alternative treatment in services without infrastructure and equipment for more complex procedures.
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References
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