Reconstruction of soft tissue after complicated calcaneal fractures. Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. [Scand J Plast Reconstr Surg Hand Surg] Journal article | | Title | Reconstruction of soft tissue after complicated calcaneal fractures. | | Author(s) | Koski EA, Kuokkanen HO, Koskinen SK, Tukiainen EJ | | Institution | Department of Plastic Surgery, Helsinki University Central Hospital, Finland. antti.koski@hus.fi | | Source | Scand J Plast Reconstr Surg Hand Surg 2004; 38(5):284-7. | | MeSH | Adolescent
Adult
Aged
Bone Screws
Calcaneus
Child
Cohort Studies
Combined Modality Therapy
Comparative Study
Female
Fracture Fixation, Internal
Fractures, Open
Graft Survival
Humans
Male
Middle Aged
Prognosis
Reconstructive Surgical Procedures
Retrospective Studies
Risk Assessment
Soft Tissue Injuries
Surgical Flaps
Treatment Outcome
Wound Healing
| | Abstract | A total of 35 flap reconstructions were done to cover exposed calcaneal bones in 31 patients. All patients had calcaneal fractures, 19 of which were primarily open. Soft tissue reconstruction for the closed fractures was indicated by a postoperative wound complication. A microvascular flap was used for reconstruction in 21 operations (gracilis, n = 11; anterolateral thigh, n = 5; rectus abdominis, n = 3; and latissimus dorsi, n = 2). A suralis neurocutaneous flap was used in eight, local muscle flaps in three, and local skin flaps in three cases. The mean follow-up time was 14 months (range 3 months-4 years). One suralis flap failed and was replaced by a latissimus dorsi flap. Necrosis of the edges that required revision affected three flaps. Deep infection developed in two patients and delayed wound healing in another four. During the follow-up the soft tissues healed in all patients and there were no signs of calcaneal osteitis. Flaps were considered too bulky in five patients. Soft tissues heal most rapidly with microvascular flaps. In the long term, gracilis muscle covered with free skin grafts gives a good contour to the foot. The suralis flap is reliable and gives a good final aesthetic outcome. Local muscles can be transposed for reconstruction in small defects. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 15513600 |
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