J Korean Orthop Assoc.  2009 Feb;44(1):54-60. 10.4055/jkoa.2009.44.1.54.

Sural Artery Flap for the Treatment of Osteomyelitis of the Lower Leg

Affiliations
  • 1Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea. jsy9528@dreamwiz.com

Abstract

PURPOSE: We report our experiences with a sural artery flap for the treatment of soft tissue defects in the lower leg with osteomyelitis.
MATERIALS AND METHODS
From 1998 to December 2004, 35 patients underwent sural artery flap surgery for soft tissue coverage in the lower leg. Among them, 13 cases also had osteomyelitis. The defects were located at the proximal 1/3 of the lower leg in 2 cases, middle 1/3 in 2 cases, and around the ankle in 9 cases. A distally based sural artery flap was performed in 11 cases, and 2 cases were treated with a proximally based sural artery flap.
RESULTS
The size of the defects ranged from 3x3 cm to 15x10 cm. Two cases showed marginal superficial necrosis that required debridement and secondary closure. After an average follow-up period of 33 months, the osteomyelitis was cured in all cases without recurrence.
CONCLUSION
A sural arteriolized flap is useful for the treatment of osteomyelitis in the lower leg accompanied by a soft tissue defect.

Keyword

Soft tissue defect; Osteomyelitis; Sural artery flap

MeSH Terms

Animals
Ankle
Arteries
Debridement
Follow-Up Studies
Humans
Leg
Necrosis
Organic Chemicals
Osteomyelitis
Recurrence
Organic Chemicals

Figure

  • Fig. 1 (A) Radiograph taken 4 months after injury shows delayed union. (B) MRI shows enhancement in medullary canal and surrounding soft tissue. (C) Radiograph taken 3 years after operation shows well healing status of osteomyelitis without an evidence of recurrence.

  • Fig. 2 (A) 6×6 cm sized soft tissue defect with osteomyelitis on proximal third of lower leg. (B) Proximally based flap was designed. (C) Photograph taken 4 years after operation shows well healing status of osteomyelitis without an evidence of recurrence.


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