title: [Application of flap or musculocutaneous flap primary transplantation in Pilon fractures of type III].
abstract: OBJECTIVE
  To discuss the value of one stage flap or musculocutaneous flap to repair the soft tissue defect in Pilon fracture.
  
  
  METHODS
  Twelve cases with Pilon fracture included 9 male and 3 female with an average age of 39.2 years ranging from 21 to 61 years. All fractures were type III according to Rüedi and Allgöwer. According to Gustilo sysytem, III a were in 4 cases, III b were in 8. A thorough debridement was made before internal fixation. After the internal fixation implanted, the tourniquet was released and a thorough debridement was made again. Be sure of the wound cleansed of all dead and foreign material, the wound was covered with local flap, musculocutaneous or gastrocnemius flaps depending on the size and localization of wound.
  
  
  RESULTS
  All the patients were followed up from 6 to 36 months, 18 months in average. The function of ankle was assessed according Mazur system. The results were excellent in 6 cases, good in 3, fair in 2 and poor in 1. No infection or necrosis happened on flaps. Although necrosis happened in the wound margin of two patients, they all healled up by conservative methods.
  
  
  CONCLUSIONS
  Primary closure of soft tissue defect in Pilon fracture using flap or musculocutaneous flap have ability to shorten the treating time and recover the function of ankle. It is important to have a thorough debridement of the dead tissue and free bone.
authors.affiliation: Department of Orthopadics, the Shangyu Hospital of TCM, Shangyu 312300, Zhejiang, China.
authors.forename: Jian-liang
authors.initials: JL
authors.lastname: Chen
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Zhen
authors.forename: Long-qun
authors.initials: LQ
authors.lastname: Zhang
authors.forename: Xiao
authors.initials: X
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D016378:Tissue Transplantation; D016896:Treatment Outcome