Vascularized Iliac Osteomuscular Free Flaps for Composite Soft Tissue and Bone Defects of the Lower Extremity

Abstract

The purpose of this study to evaluate if vascularized iliac osteomuscular free flaps, which use simple iliac graft companied by covering the iliacus muscle in the inner cortex, is a better option for soft tissue and bone defects of the lower extremity. A retrospective review was performed on 7 consecutive patients treated with vascularized iliac osteomuscular free flaps from June 1999 to March 2003. Survival of skin graft transferred onto the surface of the iliacus muscles provided indirect proof for the survival of transferred bone flap. Skin grafts survived completely in 4 cases and partially in 3 cases. The patients were followed up for 8 to 26 months (average, 14 months) and had acceptable contour and function.

Chimeric partial scapula and latissimus dorsi muscle flap for midfoot reconstruction: A case report

“…For complex wounds in the lower extremities, microsurgical reconstruction enables the replacement of all constituent elements, including soft tissue, tendon, bone, and skin 18. Vascularized osseous flaps have been used in weight‐bearing areas since 1975 4, 5, 6, 18, 19. The osteocutaneous radial forearm flap and iliac crest flap, with reliable and stable anatomical pedicles, have been used 4, 5, 6, 15.…”

“…Vascularized osseous flaps have been used in weight‐bearing areas since 1975 4, 5, 6, 18, 19. The osteocutaneous radial forearm flap and iliac crest flap, with reliable and stable anatomical pedicles, have been used 4, 5, 6, 15. The thinness of the osteocutaneous radial forearm flap and being rich in cancellous bone with lower rate of stress fracture of the iliac crest flap are what surgeons consider 4, 5, 6, 15.…”

“…The osteocutaneous radial forearm flap and iliac crest flap, with reliable and stable anatomical pedicles, have been used 4, 5, 6, 15. The thinness of the osteocutaneous radial forearm flap and being rich in cancellous bone with lower rate of stress fracture of the iliac crest flap are what surgeons consider 4, 5, 6, 15. However, even if little donor site morbidity on both flaps, neither of them own abundant muscular components 4, 5, 6, 15.…”

“…The thinness of the osteocutaneous radial forearm flap and being rich in cancellous bone with lower rate of stress fracture of the iliac crest flap are what surgeons consider 4, 5, 6, 15. However, even if little donor site morbidity on both flaps, neither of them own abundant muscular components 4, 5, 6, 15. Moreover, the patient with the osteocutaneous radial forearm flap have to scarify his radial artery and take the risk of palmaris longus tendon exposure 6.…”

“…Developments in microsurgery include bony reconstruction,3–5 particularly with iliac crest bone flaps,3–5 radial osteocutaneous flaps,6 and fibula flaps 7–10. A muscular flap is commonly used for foot reconstructions,11–15 such as a gracilis or latissimus dorsi (LD) flap.…”