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The use of free fibula-flexor hallucis longus osteomuscular flap for calcaneal reconstruction after partial calcanectomy for the chronic osteomyelitis: A case report.
Int J Surg Case Rep 2019; 65:213-216IJ

Abstract

INTRODUCTION

Calcaneal osteomyelitis poses a tough challenge for any reconstructive surgeon. The eradication of the infection and the reconstruction of the defect are the main goals of treatment.

PRESENTATION OF CASE

We present the case of a 53-year-old male with chronic calcaneal osteomyelitis. The patient was submitted to several bone and soft tissue debridements and twice the application of gentamicin/sulfate implants at the wound bed with no success. He was then submitted to a partial calcanectomy followed by obliteration of the bone defect (4.5 × 2 × 1.5 cm) with a free vascularized fibula-flexor hallucis longus osteomuscular flap (bone dimension:4.5 × 1.5 × 1.2 cm; muscle size: 4 × 1.5 × 0.5 cm). The flap remained viable, and the post-operative period was uneventful. Bone incorporation was evident nine months after the surgery with no signs of recurrent infection or avascular necrosis. Final follow up, at one year, showed an excellent functional result. The patient was able to ambulate without assistance and referred occasional minimal foot pain. Donor site morbidity was minimal.

CONCLUSION

The authors believe that this osteomuscular flap may be a valuable option to reconstruct calcaneal defects after chronic osteomyelitis.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, Hospital São José (Centro Hospitalar Lisboa Central), Lisbon, Portugal. Electronic address: Luis1989ribeiro@gmail.com.Department of Plastic and Reconstructive Surgery, Hospital São José (Centro Hospitalar Lisboa Central), Lisbon, Portugal; Department of Plastic and Reconstructive Surgery, Hospital CUF Infante Santo, Lisbon, Portugal; Anatomy Department, Nova Medical School, Universidade Nova de Lisboa, Portugal.Department of Plastic and Reconstructive Surgery, Hospital CUF Infante Santo, Lisbon, Portugal.Department of Orthopaedics, Hospital CUF Infante Santo, Lisbon, Portugal.Department of Orthopaedics, Hospital CUF Infante Santo, Lisbon, Portugal.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31733617

Citation

Mata-Ribeiro, Luís, et al. "The Use of Free Fibula-flexor Hallucis Longus Osteomuscular Flap for Calcaneal Reconstruction After Partial Calcanectomy for the Chronic Osteomyelitis: a Case Report." International Journal of Surgery Case Reports, vol. 65, 2019, pp. 213-216.
Mata-Ribeiro L, Casal D, Ferreira JA, et al. The use of free fibula-flexor hallucis longus osteomuscular flap for calcaneal reconstruction after partial calcanectomy for the chronic osteomyelitis: A case report. Int J Surg Case Rep. 2019;65:213-216.
Mata-Ribeiro, L., Casal, D., Ferreira, J. A., Costa, D. S., & Lacerda, J. (2019). The use of free fibula-flexor hallucis longus osteomuscular flap for calcaneal reconstruction after partial calcanectomy for the chronic osteomyelitis: A case report. International Journal of Surgery Case Reports, 65, pp. 213-216. doi:10.1016/j.ijscr.2019.10.046.
Mata-Ribeiro L, et al. The Use of Free Fibula-flexor Hallucis Longus Osteomuscular Flap for Calcaneal Reconstruction After Partial Calcanectomy for the Chronic Osteomyelitis: a Case Report. Int J Surg Case Rep. 2019 Oct 28;65:213-216. PubMed PMID: 31733617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of free fibula-flexor hallucis longus osteomuscular flap for calcaneal reconstruction after partial calcanectomy for the chronic osteomyelitis: A case report. AU - Mata-Ribeiro,Luís, AU - Casal,Diogo, AU - Ferreira,João Amaral, AU - Costa,Daniel Sá, AU - Lacerda,João, Y1 - 2019/10/28/ PY - 2019/10/02/received PY - 2019/10/21/accepted PY - 2019/11/17/pubmed PY - 2019/11/17/medline PY - 2019/11/17/entrez KW - Calcaneum KW - Case report KW - Fibula KW - Free flap KW - Osteomyelitis SP - 213 EP - 216 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 65 N2 - INTRODUCTION: Calcaneal osteomyelitis poses a tough challenge for any reconstructive surgeon. The eradication of the infection and the reconstruction of the defect are the main goals of treatment. PRESENTATION OF CASE: We present the case of a 53-year-old male with chronic calcaneal osteomyelitis. The patient was submitted to several bone and soft tissue debridements and twice the application of gentamicin/sulfate implants at the wound bed with no success. He was then submitted to a partial calcanectomy followed by obliteration of the bone defect (4.5 × 2 × 1.5 cm) with a free vascularized fibula-flexor hallucis longus osteomuscular flap (bone dimension:4.5 × 1.5 × 1.2 cm; muscle size: 4 × 1.5 × 0.5 cm). The flap remained viable, and the post-operative period was uneventful. Bone incorporation was evident nine months after the surgery with no signs of recurrent infection or avascular necrosis. Final follow up, at one year, showed an excellent functional result. The patient was able to ambulate without assistance and referred occasional minimal foot pain. Donor site morbidity was minimal. CONCLUSION: The authors believe that this osteomuscular flap may be a valuable option to reconstruct calcaneal defects after chronic osteomyelitis. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/31733617/The_use_of_free_fibula-flexor_hallucis_longus_osteomuscular_flap_for_calcaneal_reconstruction_after_partial_calcanectomy_for_the_chronic_osteomyelitis:_A_case_report L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(19)30592-9 DB - PRIME DP - Unbound Medicine ER -