title: One-stage reconstruction of complex lower extremity deformity combining Ilizarov external fixation and sural neurocutaneous flap.
abstract: BACKGROUND
  Complex lower extremity deformities include multidirectional foot and ankle deformities, which are complicated therapeutic and surgical challenges. Correction often requires several stages, which is time consuming and costly. The need to restore the physical, mechanical, and cosmetic aspects of the lower extremity results in a difficult balancing act between these concerns and the deformity correction and soft tissue reconstruction.
  
  
  METHODS
  Between January 2009 and September 2011, we treated 5 patients with multidirectional foot and ankle deformities. Significant mobility limitation was caused by abnormal scarring, which led to abnormal gait and weight-bearing regions. We used a sural neurocutaneous flap to repair the soft tissue defects after scar-tissue removal in all patients and placed a circular hinged Ilizarov external fixator for gradual correction.
  
  
  RESULTS
  All the flaps survived and resulted in good texture match and contour. The follow-up period was 19 to 26 months. The correction lasted 3 to 5 months, and all of the patients were able to walk with satisfactory gaits and without assistance. We encountered no complications, such as pin-track infection or drop foot in our series.
  
  
  CONCLUSIONS
  Our approach, combining a sural neurocutaneous flap and Ilizarov external fixation, was a reliable and effective tool for one-stage reconstruction of complex lower extremity deformities.
authors.affiliation: From the Department of Repair and Reconstruction Surgery, Shanghai 6th People's Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Wanrun
authors.initials: W
authors.lastname: Zhong
authors.forename: Shengdi
authors.initials: S
authors.lastname: Lu
authors.forename: Yimin
authors.initials: Y
authors.lastname: Chai
authors.forename: Gen
authors.initials: G
authors.lastname: Wen
authors.forename: Chunyang
authors.initials: C
authors.lastname: Wang
authors.forename: Pei
authors.initials: P
authors.lastname: Han
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013497:Sural Nerve / Q000601:surgery*; D013524:Surgical Flaps / Q000294:innervation*; D016896:Treatment Outcome