Free temporoparietal fascia flap in reconstruction of the lower extremity.
Twenty-one patients with open wounds of the non-weight-bearing foot or the ankle underwent coverage with a free temporoparietal fascia flap and split-thickness skin graft. Our indications for this thin, well-vascularized flap included osteomyelitis and exposed tendon, bone, or fixation hardware. The pliability of the flap allowed superior restoration of natural anatomical contours. Only one flap was completely lost (95.2% overall success). There were four cases (20%) of partial flap loss, none of which required flap revision or a new flap. Four patients (19%) experienced transient donor-site alopecia, and one patient suffered transient palsy of the temporal branch of the facial nerve. One patient (4.7%) had an area of persistent scar alopecia in the temporal scalp after a donor-site hematoma that required revision under local anesthesia. Follow-up was available on 95% of the patients and averaged 20 months (range, 1-54 months). All patients resumed weight-bearing ambulation within 1 month from operation using unmodified footwear. The free TPF flap is a reliable coverage option, with long-term durability and minimal donor-site morbidity, for relatively superficial wounds of the distal lower extremity.
Woods
J M
JM
Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-3631, USA.
Shack
R B
RB
Hagan
K F
KF
D000293:Adolescent; D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D005597:Fractures, Open / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012535:Scalp / Q000637:transplantation; D017695:Soft Tissue Injuries / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps / Q000379:methods* / Q000473:pathology; D013978:Tibial Fractures / Q000473:pathology / Q000601:surgery*