[Clinical application of tibial bone-skin flaps in treatement of infective bone-skin defects of leg].
OBJECTIVE
To investigate the clinical therapeutic effect of tibial bone-skin flaps in the repair of infective bone-skin defects of the leg.


METHODS
Between February 2000 and March 2005, 68 cases of leg infective wounds with tibial bone and skin defects were treated: 4 cases using free grafting, 64 cases using cross-leg or ipsilateral transposition grafting of tibial bone-skin flaps so that the tibial support continuity of the affected leg could be reconstructed and the wound could be covered at one stage. The skin flap area ranged from 9 cm x 4 cm to 25 cm x 12 cm and the bone flap length ranged from 6 cm to 21 cm.


RESULTS
The flaps were completely survived in 67 of the 68 cases except 1 case which was repaired by fibular bone-skin flaps because of the failed blood-vessel anastomosis; the bone flaps were healed in 66 cases, except 1 case which had delayed union of the proximal end through 6-month follow-up because tibial bone flap was lengthened, leading to long soft tissue stripping of the proximal end. All the 68 patients were followed up 6 months to 5 years. The leg function and contour were satisfactory 2 years after operation. Those patients followed up more than 2 years showed normal weight loading walking without obviously abnormal gait, and can engaged in original work.


CONCLUSIONS
On the basis of sufficient anti-infection, the one-stage reconstruction of tibial support continuity and the covering of wound by the three methods are suitable for many types of leg bone and skin defects, have a great application value and high successful rate and can retain the affected limb and create the conditions for the functional recovery.
Jia
Hongwei
H
Luoyang Orthopedic-Traumatological Hospital and Institute of Henan Province, Luoyang Henan, 471002, P. R. China. lyduwei@126.com
Cheng
Chunsheng
C
Lv
Songfeng
S
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D002648:Child; D062109:Dermatologic Surgical Procedures; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007869:Leg Injuries / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012867:Skin / Q000293:injuries; D016038:Skin Transplantation; D013524:Surgical Flaps; D013977:Tibia / Q000293:injuries / Q000601:surgery*; D013978:Tibial Fractures / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
D004365:Drugs, Chinese Herbal