Overcoming the weight of reconstruction-anterolateral thigh flap reconstructions of the weight-bearing surface within the foot. Outcome assessment using foot function index.

IF 1.4 Q3 ORTHOPEDICS
Jakub Opyrchal, Dominika Krakowczyk, Daniel Bula, Krzysztof Dowgierd, Lukasz Krakowczyk
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引用次数: 0

Abstract

Purpose: Weight-bearing region among the plantar surface of the foot is critical for proper functioning of the lower limb and serves as a point of resistance and support for the weight of the whole body. However, when foot injury is more complex as well as involves exposure of bones, tendons or joints-the adequate soft tissue coverage is needed to facilitate healing and prevent future cutaneous fistulas. Free flaps meet all of these criteria and with current advances within the field of microsurgery-it is not disfiguring, nor does it bring any additional burden to the patient.

Methods: Informations concerning extensive plantar reconstructions in adolescent patients, using free fasciocutaneous flaps were gathered retrospectively by the authors. The mean follow-up was 47 months. To examine the functional outcome-all patients patient were assessed using foot function index (FFI).

Results: In all cases soft tissue coverage of the defect and appropriate function were provided. No postoperative complications were reported apart from minor pressure ulcer which was treated conservatively. The mean FFI score was 8.9%, which is considered as a very good functional outcome. No patient reported cutaneous fistulas in the late postoperative period.

Conclusions: Reconstructions of the weight-bearing surface of the foot with anterolateral thigh free flaps provide durable and functionally satisfactory outcome. However, in some cases they may require flap adjustment in the second surgical procedure, to fit the healthy, untreated foot. In all cases, the outcome was fully accepted both by young patients as well as their parents.

克服重建的重量-大腿前外侧皮瓣重建足内承重面。用足部功能指数评价结果。
目的:足的足底面承重区是下肢正常活动的关键部位,是全身重量的阻力和支撑点。然而,当足部损伤比较复杂,并且涉及骨骼、肌腱或关节暴露时,需要足够的软组织覆盖以促进愈合并防止未来的皮肤瘘。自由皮瓣符合所有这些标准,并且随着显微外科领域的发展,它不会毁容,也不会给患者带来任何额外的负担。方法:回顾性收集青少年患者应用游离筋膜皮瓣进行足底重建术的资料。平均随访时间为47个月。为了检查功能结果,所有患者都使用足功能指数(FFI)进行评估。结果:在所有病例中,软组织覆盖缺损并提供适当的功能。术后除轻微压疮外,无其他并发症。平均FFI评分为8.9%,这被认为是一个非常好的功能结果。术后后期无患者报告皮肤瘘管。结论:用大腿前外侧游离皮瓣重建足部负重面具有持久和功能满意的效果。然而,在某些情况下,他们可能需要在第二次手术中调整皮瓣,以适应健康的、未经治疗的足部。在所有的案例中,结果都被年轻患者和他们的父母完全接受。
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来源期刊
CiteScore
3.00
自引率
5.90%
发文量
265
审稿时长
3-8 weeks
期刊介绍: The European Journal of Orthopaedic Surgery and Traumatology (EJOST) aims to publish high quality Orthopedic scientific work. The objective of our journal is to disseminate meaningful, impactful, clinically relevant work from each and every region of the world, that has the potential to change and or inform clinical practice.
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