title: A "hybrid" sural flap for treatment of chronic calcaneal osteomyelitis.
abstract: BACKGROUND
  The treatment of chronic calcaneal osteomyelitis remains a challenge for orthopedic and plastic surgeons. The basis of surgical therapy includes thorough debridement of infected tissue and reconstruction with well-vascularized flaps.
  
  
  METHODS
  A "hybrid" sural flap composed of an adiponeurofascial flap proximally and a neurofasciocutaneous flap distally is described here. The adiponeurofascial flap was used to obliterate the bone cavity, and the distal part was used to resurface soft tissue defects. Five patients with chronic calcaneal osteomyelitis were treated with this modified sural flap.
  
  
  RESULTS
  The size of the adiponeurofascial flap ranged from 5.0 × 4.0 cm to 13.0 × 5.0 cm, and that of the neurofasciocutaneous flap ranged from 6.5 × 3.0 cm to 6.0 × 8.0 cm. The donor defects were covered with skin grafts in three patients and closed primarily in two patients. All the flaps survived completely without any complications, the skin graft and the skin over the adiponeurofascial flap healed uneventfully. There was no evidence of recurrent infection during the follow-up period.
  
  
  CONCLUSIONS
  The modified "hybrid" sural flap is simple and reliable and is a good candidate for treatment of chronic calcaneal osteomyelitis.
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Chun-Yang
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Lu-Yuan
authors.initials: LY
authors.lastname: Sun
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Chai
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Pei
authors.initials: P
authors.lastname: Han
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Gen
authors.initials: G
authors.lastname: Wen
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
mesh_terms: D000328:Adult; D002111:Calcaneus / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D002908:Chronic Disease; D003646:Debridement; D005205:Fascia / Q000637:transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012501:Saphenous Vein / Q000637:transplantation; D016038:Skin Transplantation / Q000379:methods; D013497:Sural Nerve / Q000637:transplantation*; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation; D016896:Treatment Outcome