Chimeric partial scapula and latissimus dorsi muscle flap for midfoot reconstruction: a case report.
Free muscular, osteomuscular, and fasciocutaneous flaps are widely used for midfoot reconstruction. The latissimus dorsi (LD) flap is rich in muscle mass, but the weight-bearing ability of the reconstruction with its combination with a scapula or rib has not been evaluated. Here, we report a case of reconstruction of the right midfoot with the trauma-related osteomyelitis using a free chimeric scapula and LD muscle flap in a 59-year-old woman with diabetes mellitus. After radical debridement and sequestrectomy, a 7 × 3 cm(2) wound with a 5 × 3 cm(2) bony defect was reconstructed with the chimeric scapula and LD muscle flap. The postoperative course was uneventful. The bony union was achieved 6 months after surgery. In 14 months follow-up, no clinical complications including a new ulcer or stress fracture were noted. At the end of follow-up, the gait analysis showed an unbalanced stress distribution on the right foot and a valgus gait. We suggest that this chimeric scapula and LD muscle flap may be an alternative option for midfoot reconstruction.
Plastic Division, Department of Surgery, Shin Kong Wo Ho-Su Memorial Hospital, Taiwan, Republic of China.
Cha-Chun
CC
Chen
Chi-Huwang
CH
Lin
Yu-Hsien
YH
Lin
D017719:Diabetic Foot / Q000150:complications; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery; D058752:Free Tissue Flaps; D006801:Humans; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012540:Scapula / Q000637:transplantation*; D013639:Tarsal Bones / Q000293:injuries / Q000473:pathology / Q000601:surgery