J Korean Soc Microsurg.  2009 Nov;18(2):49-54.

Muscle Free Flap Transplantation in Chronic Osteomyelitis of the Lower Extremities

• Lee JM
• Song KH
• Park JH

Abstract

PURPOSE
To evaluate the result of muscle free flap transplantation in chronic osteomyelitis of the tibia and calcaneus occurred from open fractures and exposed bones and internal fixatives.
MATERIALS AND METHODS
The free muscle flap were transferred in the tibia and calcaneus and followed up average 7.3 years at the department of orthopedic surgery from March 1997 to September 2009. Six patients were male and 1 case female averaged 50.3 years of age. Two latissimus dorsi myocutaneous free flaps were transplanted to the exposed 2/3 of the tibia with soft tissue defect, one rectus abdominis muscle free flap to the mid 1/3 of the tibia and four gracilis muscle free flaps to the distal 1/3 of the tibia and calcaneus.
RESULTS
At average 7.2 years follow-up, all of the 7 cases obtained solid bone union in the X-ray and kept sound soft tissues without pus discharges. The overall result of bone union, healed soft tissues defect and normal knee and ankle joint range of motion were excellent.
CONCLUSION
The free muscle flap transferred to the chronic osteomyelitis of the tibia and calcaneus showed excellent results in bone union and eradication of the pus forming bacteria by its abundant blood flow.

Keyword

Free muscle flap; Chronic osteomyelitis

MeSH Terms

Ankle Joint
Bacteria
Calcaneus
Female
Follow-Up Studies
Fractures, Open
Free Tissue Flaps
Humans
Knee
Lower Extremity
Male
Muscles
Orthopedics
Osteomyelitis
Range of Motion, Articular
Rectus Abdominis
Suppuration
Tibia
Transplants