Concurrent internal fixation and soft tissue reconstruction by distally based sural flap: a practicable scheme for complex distal tibial fractures

Jitprapaikulsarn, Surasak; Sukha, Kritsada; Patamamongkonchai, Chawanan; Gromprasit, Arthit; Thremthakanpon, Witoon

doi:10.1007/s00590-020-02827-8

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…Distraction osteogenesis using the Ilizarov method can maintain the reduction of fractures or nonunions, stimulate bone formation, eliminate the need for implanted hardware, provide a stable platform for soft tissue reconstruction, and allow full weight-bearing [ 10 - 11 ]. Jitprapaikulsarn et al described the simultaneous use of internal fixation using plates and screws and soft tissue coverage by a distally-based sural flap for complex Gustilo IIIB open fractures as an effective and reproducible technique [ 12 ]. To date, the role of distally-based fasciocutaneous flaps in concurrent ring external fixation using the Ilizarov method and soft tissue coverage is still not specifically described.…”

Section: Discussionmentioning

confidence: 99%

A Case of Reconstruction of an Open Tibial Fracture (Gustilo-Anderson Type IIIB) With Severe Skin and Bone Loss Using Corticocancellous Bone Plugs From the Iliac Crest and an Ilizarov Frame

Papagiannis¹,

Sinos²,

Vrachnis³

et al. 2022

Cureus

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Gustilo-Anderson type IIIB fractures include open fractures with extensive soft tissue injury with periosteal stripping and bony exposure. They are usually associated with massive contamination and can be challenging even for experienced surgeons. A multidisciplinary approach among plastic and trauma surgeons is often required. We present a case of a 58-year-old man with a type IIIB open tibial fracture initially managed with a bridging external fixation and primary skin closure using a fasciocutaneous sural flap. Two months later, there was no evidence of fracture healing and an Ilizarov device was applied with corticotomy at the proximal tibial metaphysis, which was modified five months later without changing the frame, placing autogenous iliac bone plugs at the fracture site using the mosaicplasty harvesting technique. Seven months after its initial placement, the Ilizarov device was removed allowing full weightbearing, with callus formation present at 10-month follow-up. Finally, the patient showed acceptable radiological and functional outcomes after a follow-up of two years. The Ilizarov method should be considered as a therapeutic option for complicated open fractures with severe bone and skin loss. The patient should be fully informed about the complexity of these fractures and the necessity of multiple surgical interventions in order to have realistic expectations.

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Section: Discussionmentioning

confidence: 99%