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Reconstruction of Pretibial Defect Using Bone-Anchored Advancement Flap

Journal of Wound Management and Research 2021년 17권 1호 p.72 ~ 75
김수환, 이경태, 박진우,
소속 상세정보
김수환 ( Kim Su-Hwan ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Plastic and Reconstructive Surgery
이경태 ( Lee Kyeong-Tae ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Plastic and Reconstructive Surgery
박진우 ( Park Jin-Woo ) - Ewha Womans University School of Medicine Ewha Womans University Mokdong Hospital Department of Plastic and Reconstructive Surgery

Abstract


While free flaps have been widely used for reconstruction of pretibial defects, the extended operation times are known to be a major drawback. This report presents a case of successful lower leg reconstruction for a large pretibial defect with a bone-anchored advancement flap and split-thickness skin graft. A 59-year-old female patient underwent wide excision of sarcoma on the pretibial area. The skin defect measured 14×6 cm with a 10×2 cm exposure of the tibia in the medial aspect of the defect. An advancement flap was elevated from the medial side of the tibia to cover the exposed bone. The bone defect was reconstructed by the advancement flap with the aid of an anchoring suture to the tibia. Remaining defect with exposed muscles was covered using split-thickness skin graft. No immediate postoperative complication developed. One year after the operation, well-contoured reconstruction was achieved without functional morbidities. In reconstruction of pretibial defects, bone-anchored advancement flap can be considered in patients who are reluctant to or have risk factors for free flap reconstruction.

키워드

Diabetic foot; Lower leg reconstruction; Perforator flap

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