Treatment of Chronic Osteomyelitis in Lower limb using Anterolateral Thigh perforator Flaps

Shin, Hyun Woo; Hong, Joon Pio

Abstract

Management of chronic osteomyelitis in lower extremity caused by trauma or diabetes has always been difficult. The aim of treatment for these patients are eradication of infection with preservation of the gait function of the leg. Coverage with local and free muscle flaps after complete surgical excision of infected soft tissue and osseous structures is major strategy for treatment of chronic osteomyelitis. There is no doubt that muscle provides good blood flow, thus improves bone healing and increases resistance to bacterial inoculation. But accompanying problems are seen in cases with shallow dead space. In this paper the experience with the use of anterolateral thigh perforator flaps for treatment of osteomyelits is presented. Complete debridement of all non viable, infected and scar tissue and coverage with anterolateral thigh flaps were coupled with through effective antibiotic course in all cases. Follow up periods ranged from 6 to 12 months. All flaps survived completely and osteomyelitis of all cases were subsided. Acceptable gait function was recovered. The Anterolateral thigh perforator flaps can adequate coverage for the treatment of bone infections. It can also be used with combined muscle flaps for reconstruction of large dead space. A dvantages such as acceptable donor site morbidity, short operation time, good sensated reconstruction, and acceptable contours are seen. Reconstruction with anterolateral perforator flaps after complete debridement in the lower limb achieves satisfactory aesthetic and functional results.