Management of infected tibial fractures and chronic tibial osteomyelitis by muscle flap transfer: a comparison of two series of patients.
OBJECTIVE
The goal of this work is to compare therapeutic results of two groups of patients with an infected fracture or chronic osteomyelitis of the lower leg and ankle joint treated by the method of radical debridement followed by free flap transfer or muscle transposition.


METHODS
In the period between 1 January 2002 and 30 September 2007 the authors used this method in the treatment of 52 patients (10 females and 42 males) with the average age of 44 years (ages ranged from 10 to 67). The observed group of patients was divided into retrospective and prospective subgroups.


METHODS
The difference between the retrospective and prospective parts of the study was how radical the debridement and necrectomy of the soft tissues was. A comparison of therapeutic results in both subgroups was made by evaluation of the amounts of postoperative complications, number of follow-up surgeries and the actual weight-bearing ability of the treated extremity.


RESULTS
The difference in the number of postsurgical complications (7 versus 2) was not significant (p=0.123), and neither was the difference in the number of follow-up surgeries (20 versus 17, p=0.706). The difference in the number of patients with fully weightbearing extremities (21 versus 22) was also not significant (p=0.670).


CONCLUSIONS
The authors feel that analysis of complications showed somewhat better results in the prospective part of the study, despite the lack of statistical proof. Therefore the authors regard the method of extensive debridement with the following coverage of the soft tissue defect by muscle flap as suitable for the treatment of infected fractures in the area of the lower leg and ankle joint and the treatment of osteomyelitis of the tibia.
Záhorka
J
J
Department of Orthopaedics, Third Faculty of Medicine, Charles University, Prague, Czech Republic. jiri.zahorka@seznam.cz
Nejedlý
A
A
Tvrdek
M
M
Dzupa
V
V
D000328:Adult; D000368:Aged; D000843:Ankle Joint; D002648:Child; D002908:Chronic Disease; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery*; D055815:Young Adult