Medial malleolus and deltoid ligament reconstruction in open ankle fractures with combination of vascularized fibular head osteo-tendinous flap and free flap transfers
Version of Record online: 16 JUL 2009
Copyright © 2009 Wiley-Liss, Inc.
Volume 29, Issue 8, pages 630–635, November 2009
How to Cite
Wu, S.-P., Zhang, F.-H., Yu, F.-B. and Zhou, R. (2009), Medial malleolus and deltoid ligament reconstruction in open ankle fractures with combination of vascularized fibular head osteo-tendinous flap and free flap transfers. Microsurgery, 29: 630–635. doi: 10.1002/micr.20689
- Issue online: 2 NOV 2009
- Version of Record online: 16 JUL 2009
- Manuscript Accepted: 11 JUN 2009
- Manuscript Received: 27 OCT 2008
Treatment of the traumatic bone and soft tissue defect of the medial ankle is a challenge in reconstructive orthopedic surgery. In this report, we described a novel reconstruction procedure for the medial malleolus reconstruction using microsurgical transfer of the fibular head osteo-tendinous flap combined with a free latissimus dorsi flap (free LD flap) or a free anterolateral thigh flap (free ALT flap) in six patients. The sizes of the wounds ranged from 10 × 8 cm to 24 × 10 cm, and the sizes of the LD and ALT flaps were from 12 × 9 cm to 24 × 12 cm. All transplants survived. Five patients had primary wound healing. One patient had fibular graft and soft tissue infection that caused delayed healing. On average 4 months after surgery, all patients were able to stand and walk without crutch assistance. With a mean follow-up of 3.5 years (range, 1–5 years), all patients achieved stable ankles and were satisfied with the range of motion with excellent American Orthopedic Foot and Ankle Society functional scores (>85). The fibular head resembles the medial malleolus in morphology. Vascularized fibular head transfer combined with a free flap provides satisfactory results for complex medial malleolus reconstruction. © 2009 Wiley-Liss, Inc. Microsurgery, 2009.