Reconstruction of foot defects due to mine explosion using muscle flaps

Abstract

Landmine explosions bring a formidable challenge to both patients and reconstructive surgeons. Free tissue transfer is the only method of repairing such extensive soft tissue defects of the foot after serial debridements. Sixty-five consecutive free muscle flap transfers were performed in 54 patients who had foot defects involving soft tissue and bone due to mine explosions. Although posttraumatic vessel disease had complicated most of the cases, overall flap survival rate was 83%. Each patient was ambulatory. Ulceration in long-term period was seen in only one patient. Eighty-five percent of patients with successful bone reconstruction and 41.6% of patients without adequate bone replacement demonstrated normal weightbearing in footprints and gait analysis. Free muscle flaps with split thickness skin graft and bone replacement are recommended for the reconstruction of such devastating wounds.

Amputations of the Lower Limb: A Multidisciplinary Consensus

“…This view would be consistent with the view of other authors who advocate preserving maximum soft tissue and bone (8)(9). As with the soft tissues, the bone should not be cut at the proposed site of definitive amputation.…”

“…Amputation, if appropriate, can be carried out following evacuation to a base hospital. This approach retains the possibility of reconstruction, even when significant foot injuries have occurred (8). When local facilities preclude complex reconstruction and evacuation are unavailable then initial amputation may be more appropriate.…”

Evaluation of Late Functional Results of Patients Treated with Free Muscle Flaps for Heel Defects Caused by Land-Mine Explosions

“…Scapular flaps, latissimus dorsi flaps, rectus abdominis flaps, and radial forearm flaps are among those that were successfully transferred. 2,3,[11][12][13] Late functional results have been evaluated and reported in very few studies. [11][12][13][14] May et al…”

“…2 In that study, the advantages of muscle flaps covered with a skin graft for reconstruction of composite defects of the heel region were discussed. In the present study, we aimed to investigate the long-term functional results of sophisticated reconstructions in the same population on which we reported previously.…”

Mine Blast Injuries - Our Experience

“…By providing skin coverage in 4 cases and external fixation in 2 cases in our series we prevented a significant disability in these patients. In a series from Gulhane Military Medical Academy, Turkey 65 consecutive free muscle flap transfers were performed in 54 patients who had foot defects involving soft tissue and bone due to mine explosions and in them the overall flap survival rate was 83% [7].…”