| Foot and ankle reconstruction using the radial forearm flap: a review of 25 cases. | |
| | |
MedLine Citation:
|
PMID: 9810997 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Twenty-five patients underwent soft-tissue reconstruction of the different anatomic regions of the foot and ankle using the microvascular radial forearm free flap. The patients, 19 men and 6 women, ranged in age from 3 to 80 years (mean, 48.4 years). Indications for the surgery included diabetes and/or vascular insufficiency (10 patients), trauma (9 patients), tumor (3 patients), gunshot wound (2 patients), and burn (1 patient). Osteomyelitis occurred in patients with traumatic (3 patients) and diabetic (3 patients) wounds. The weight-bearing surface of the foot was involved in eight patients. Defects ranged in size from 45 to 210 cm2 (mean, 100.4 cm2). The radial forearm flap was successful in 23 of 25 cases (92 percent). Flap complications included flap loss (two patients), infection (three patients), and minor wound dehiscence at the flap-leg skin interface (two patients). Recurrent ulceration occurred in two patients; both were diabetics with weight-bearing flaps. Donor site complications included partial skin graft loss with tendon exposure in two patients; both healed with conservative management. Recurrent or persistent osteomyelitis was not seen in any of the patients. Of the eight patients with weight-bearing flaps, four were ambulatory, one had limited ambulation, one was nonambulatory, one had too short a follow-up, and one suffered flap loss. Two patients required modified shoes. Debulking was performed in one patient. Follow-up ranged from 2 to 72 months (mean, 24.9 months). The radial forearm flap meets most of the anatomic prerequisites for the ideal foot flap. It facilitates the restoration of normal foot contour by replacing "like-with-like," allowing patients to use normal shoes without the need for debulking (except in one patient); it provides a durable and stable weight-bearing plantar surface during ambulation; it achieves excellent aesthetic results without the dryness or cracking of the hypertrophied skin-grafted muscle; and it permits sensory reinnervation. We have found it especially useful for resurfacing the dorsum, ankle, and forefoot, moderate-sized defects, weight-bearing surfaces, and osteomyelitic wounds. |
| | |
Authors:
|
N Weinzweig; B W Davies |
Related Documents
:
|
20613547 - Low-frequency repetitive transcranial magnetic stimulation and intensive occupational t... 21571767 - Low-dose rituximab therapy for refractory thrombocytopenia in patients with systemic lu... 21915057 - Female patients in fertile age with chronic hepatitis c, easy genotype, and persistentl... 22207887 - Clinical features of cardio-renal syndrome in a cohort of consecutive patients admitted... 19854037 - Systemic and airway inflammation and the presence of emphysema in patients with copd. 22230647 - Effects of lithium therapy on na(+)-k(+)-atpase activity and lipid peroxidation in bipo... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Plastic and reconstructive surgery Volume: 102 ISSN: 0032-1052 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 1998 Nov |
Date Detail:
|
Created Date: 1998-12-01 Completed Date: 1998-12-01 Revised Date: 2011-02-16 |
Medline Journal Info:
|
Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 1999-2005 Citation Subset: AIM; IM |
Affiliation:
|
Department of Orthopaedic Surgery, University of Illinois at Chicago and Cook County Hospital 60612-7316, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Ankle / surgery* Child, Preschool Diabetic Angiopathies / surgery Female Follow-Up Studies Foot / surgery* Foot Injuries / surgery Forearm Humans Male Microsurgery Middle Aged Neoplasms / surgery Osteomyelitis / complications Postoperative Complications Reconstructive Surgical Procedures / methods* Surgical Flaps* Treatment Outcome Venous Insufficiency / surgery Weight-Bearing |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Analysis of digital pulse-volume recordings with radial and ulnar artery compression.
Next Document: Improvement in resource utilization after development of a clinical pathway for patients with pressu...