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

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2.	王成琪.皮瓣和肌皮瓣修复创伤性组织缺损的作用.中华显微外科杂志, 1999, 22(1): 11-12.
3.	吴攀峰, 唐举玉, 李康华, 等.旋髂深动脉嵌合穿支皮瓣修复四肢骨和软组织缺损.中华显微外科杂志, 2014, 37(6): 524-527.
4.	申屠刚, 王刚, 李强, 等.吻合血管的髂骨瓣移植修复四肢骨缺损22例.中华显微外科杂志, 2015, 38(2):173-175.
5.	刘勇, 张成进, 付兴茂, 等.跨供区髂骨皮瓣一期修复肢体大面积骨与软组织缺损.中华骨科杂志, 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.	张斌, 黄富国, 杨志明.吻合血管骨瓣移植修复骨折不愈合或大块骨组织缺损.中国修复重建外科杂志, 2002, 16(3): 185-187.
8.	许亚军, 芮永军, 孙振中, 等.游离髂腹部(髂骨)皮瓣的血管分型.实用手外科杂志, 2015, 29(2): 123-125, 190.
9.	孙贺, 徐达传, 杜心如, 等.旋髂深血管蒂髂骨瓣转位腰骶椎植骨的应用解剖.中国临床解剖学杂志, 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.	朱跃良, 梅良斌, 吕乾, 等.足踝软组织重建的皮瓣选择策略: 14种皮瓣226例分析.中华显微外科杂志, 2014, 37(3): 242-245.
12.	刘会仁, 刘家寅, 张艳茂, 等.股前外侧穿支皮瓣的临床应用与分型.中华显微外科杂志, 2016, 39(2): 119-122.
13.	隋海明, 丛海波, 翟建国, 等.大面积股前外侧皮瓣的设计与切取:附28例报告.中华显微外科杂志, 2014, 37(2): 143-146.
14.	谭屏, 汤玉泉, 曾凯生, 等.游离股前外侧穿支皮瓣修复大面积皮肤软组织缺损的临床研究.中国骨与关节损伤杂志, 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.	李涛, 陈振兵, 丛晓斌, 等.吻合浅静脉的穿支螺旋桨皮瓣的临床应用.中华整形外科杂志, 2015, 31(2): 107-110.
17.	傅尚俊, 杨晓东, 杨锦, 等.游离股前外皮瓣移植术后静脉危象的病因探讨.中华手外科杂志, 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.皮瓣和肌皮瓣修复创伤性组织缺损的作用.中华显微外科杂志, 1999, 22(1): 11-12.
3. 吴攀峰, 唐举玉, 李康华, 等.旋髂深动脉嵌合穿支皮瓣修复四肢骨和软组织缺损.中华显微外科杂志, 2014, 37(6): 524-527.
4. 申屠刚, 王刚, 李强, 等.吻合血管的髂骨瓣移植修复四肢骨缺损22例.中华显微外科杂志, 2015, 38(2):173-175.
5. 刘勇, 张成进, 付兴茂, 等.跨供区髂骨皮瓣一期修复肢体大面积骨与软组织缺损.中华骨科杂志, 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. 张斌, 黄富国, 杨志明.吻合血管骨瓣移植修复骨折不愈合或大块骨组织缺损.中国修复重建外科杂志, 2002, 16(3): 185-187.
8. 许亚军, 芮永军, 孙振中, 等.游离髂腹部(髂骨)皮瓣的血管分型.实用手外科杂志, 2015, 29(2): 123-125, 190.
9. 孙贺, 徐达传, 杜心如, 等.旋髂深血管蒂髂骨瓣转位腰骶椎植骨的应用解剖.中国临床解剖学杂志, 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. 朱跃良, 梅良斌, 吕乾, 等.足踝软组织重建的皮瓣选择策略: 14种皮瓣226例分析.中华显微外科杂志, 2014, 37(3): 242-245.
12. 刘会仁, 刘家寅, 张艳茂, 等.股前外侧穿支皮瓣的临床应用与分型.中华显微外科杂志, 2016, 39(2): 119-122.
13. 隋海明, 丛海波, 翟建国, 等.大面积股前外侧皮瓣的设计与切取:附28例报告.中华显微外科杂志, 2014, 37(2): 143-146.
14. 谭屏, 汤玉泉, 曾凯生, 等.游离股前外侧穿支皮瓣修复大面积皮肤软组织缺损的临床研究.中国骨与关节损伤杂志, 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. 李涛, 陈振兵, 丛晓斌, 等.吻合浅静脉的穿支螺旋桨皮瓣的临床应用.中华整形外科杂志, 2015, 31(2): 107-110.
17. 傅尚俊, 杨晓东, 杨锦, 等.游离股前外皮瓣移植术后静脉危象的病因探讨.中华手外科杂志, 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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