Distally Based Medial Hemisoleus Muscle Flap for Wound Coverage in the Distal Third of the Leg

2020 ◽  
Vol 37 (4) ◽  
pp. 631-647
Author(s):  
Ahmed Ashraf Fisal ◽  
Mohamed Abdel-Hamid Romeih ◽  
Lotfy Mohamed Younes ◽  
Mahmoud El-Rosasy ◽  
Pedro Rodriguez ◽  
...  
1987 ◽  
Vol 40 (1) ◽  
pp. 20-26 ◽  
Author(s):  
M.S. Fayman ◽  
F. Orak ◽  
B. Hugo ◽  
S.D. Berson

2016 ◽  
Vol 2 (1) ◽  
pp. 31-37
Author(s):  
Daniel A. Wolff ◽  
Gustavo J. Armand Ugón ◽  
Jesús R. Manzani

Introducción: El éxito de éste colgajo depende de la anatomía vascular de su pedículo y de la existencia de anastomosis con pedículos proximales. Los estudios vasculares anatómicos en cadáveres fundan las bases para la realización de colgajos musculares. El cirujano debe conocer cuales de los resultados de un estudio cadavérico son aplicables al paciente. Objetivos: Estudiar en cadáveres el número de pedículos distales, su topografía y la existencia de anastomosis con vasos proximales. Luego comparar estos datos con los hallados en pacientes. Material y Métodos: En 9 piernas cadavéricas se estudió la anatomía de los pedículos distales. En 5 pacientes se realizó colgajo de hemisóleo a pedículo distal y se verificó la correspondencia de los datos cadavéricos con los hallados en el vivo. Resultados: En el grupo cadavérico los pedículos distales para el músculo sóleo se originaron tanto de la arteria tibial posterior como de la peronea. El vaso mas distal se encontró en promedio a 6,32 cm de la línea intermaleolar y su origen mas frecuente fue la arteria tibial posterior. La presencia de anastomosis no fue demostrable en las disecciones cadavéricas pero si en el vivo.       Conclusiones: Los resultados cadavéricos fueron comparables con los hallazgos del modelo vivo, salvo en la identificación de anastomosis, sólo evidenciables en éstos últimos. Esta información es útil para el abordaje y localización del pedículo distal que nutre el colgajo, pero no para definir el territorio anatómico del vaso. Por lo tanto, debe conocerse que datos originados de estudios cadavéricos pueden aplicarse al vivo. Introduction: The success of this flap depends on the vascular anatomy of its pedicle and on the existence of anastomosis with proximal pedicles. The anatomic cadaveric vascular studies set the foundation for muscle flap designs. Surgeons should know which results of cadaveric studies are applicable to the patient. Our objective was to study, in cadavers, the number and situation of distal pedicles to the soleous muscle and the existence of anastomosis between them and proximal dominant vessels for this muscle, and to compare this data with those found in patients. Material and Methods: The anatomy of distal pedicles was studied in nine cadaveric legs. Distally based hemisoleus flap was performed in five patients. The correspondence between cadaveric and patients data was verified. Results: Cadaveric group distal pedicles for soleus muscle were originated from the posterior tibial artery and also from the fibular artery. The most distal vessel was found at an average of 6.32 cm from the intermaleolar line. Its most frequent origin was the posterior tibial artery. The presence of anastomosis was demonstrated in patients but not in cadaveric dissections. Conclusions: Cadaveric results were comparable with those found in patients, except for the identification of the anastomosis. This information is useful for the localization and surgical approach of the distal pedicle that nourish the flap, but not to define the anatomical territory of the vessel. Therefore, it should be known which cadaveric data can be applied to the patients.   


2013 ◽  
Vol 52 (4) ◽  
pp. 543-546 ◽  
Author(s):  
Edgardo R. Rodriguez Collazo ◽  
Christopher Bibbo ◽  
R. Jordan Mechell ◽  
Adam Arendt

Author(s):  
Ayub Ali ◽  
Mizanur Rahman ◽  
Sajedur Reza Faruquee ◽  
Tazul Islam ◽  
Zamil Zaidur Rahim ◽  
...  

<p class="abstract"><strong>Background:</strong> The open fracture of tibia-fibula Gustilo type III-B may threaten the survival of the injured leg. The objective of<strong> </strong>the study purpose was to see the effect of early coverage following fixation of open tibial shaft fracture<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This clinical trial was carried out in National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka from July 2004 to June 2006 for a period of two (2) years. Patients at age group of 18 years or above with both sexes presented with open fracture shaft of tibia-fibula Gustilo type III-B were selected as study population. The patients were surgically managed by SIGN Interlocking nail and wound coverage by muscle flap within 72 hours of injury. Bacteriological study of the wound was done in all cases.<strong> </strong>All fixation and coverage were performed within 72 hours of injury. Patients grading improved on subsequent follow up. Evaluation of results was done at every post-operative follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total number of<strong> </strong>12 young patients with open fracture tibia-fibula Gustilo III-B were recruited for this study. Their age varies from 18 years to 48 years. A total number of 83.33% cases wound debridement was done within 12 hours of injury. Most of the soft tissue healed (91.67%) within 0 to 20 days.  There were no cases developed limb length discrepancy angulations or rotation. Superficial infections were occurred in 1(8.33%) case but no evidence of deep infection. In this study excellent result were obtained from 9 cases (75%), good results were found in 2 cases (16.67%), fair results from 1 case (8.33%)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> In conclusion early intramedullary fixation and exposed bone coverage by muscle flap is very important for prevention of infection, minimizing bone death simultaneously enhances bone healing<span lang="EN-IN">.</span></p>


2019 ◽  
Vol 22 (2) ◽  
pp. 108-112 ◽  
Author(s):  
Subhash Sahu ◽  
Amish Jayantilal Gohil ◽  
Shweta Patil ◽  
Shashank Lamba ◽  
Kingsly Paul ◽  
...  

Author(s):  
Luca Vaienti ◽  
Giuseppe Cottone ◽  
Giovanna Zaccaria ◽  
Emanuele Rampino Cordaro ◽  
Francesco Amendola

The aim of this single-center, retrospective study is to demonstrate the effectiveness of distally based peroneus brevis muscle flap as first therapeutic option for infections after Achilles tendon open repair. We retrospectively analyzed 14 consecutive patients with complete Achilles tendon rupture and developing surgical site infection after an attempt of open surgical repair. Every patient was reconstructed with distally base peroneus brevis muscle flap. The primary outcome was the return to work and the initiation of full weight-bearing. Secondary outcomes were complication rate and time needed to return to work. A review of the literature was conducted to better define the actual standard treatment. Each patient returned to work. No flap necrosis occurred. Two minor healing delays and one hematoma were reported. Median time to wound healing was 17 days (interquartile range [IQR] = 13-20). Median time to full weight-bearing was 52 days (IQR = 47-55). Median follow-up (FU) was 21 months. Distally based peroneus brevis flap is a safe treatment for surgical site infections after Achilles tendon rupture repair. Patients regained full weight-bearing after a median time of 52 days from the surgical reconstruction. No major complications were observed. This flap clearly emerges as first reconstructive option for complications after surgery of Achilles tendon region.


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