22. Clinical characteristic and treatment of complex soft tissue defects of the ankle and foot

Vu Thi Dung, Pham Thi Viet Dung, Hoang Tuan Anh

Main Article Content

Abstract

The objectives of this study are to describe the clinical characteristic of ankle and foot defects, propose the reconstructive treatment based on level of injury, and describle different type of ALT flap used to reconstruct the ankle and foot defects. The research is conducted on 162 patients with 163 soft tissue defects in the ankle and foot treated at Saint Paul Hospital and Hanoi Medical University Hospital from August 2016 to November 2022. The size of defects ranged from 6cm2 to 650cm2. The rate of complicated defects of the ankle and foot was 76.07%. Among the treatments performed, 76 defects of the foot were reconstructed by skin graft, 26 defects were treated by local flaps, 16 defects were treated by regional flaps, and 45 defects were reconstructed by ALT flap. In conclusion, clinical characteristic of foot and ankle defects can significantly inform evaluate reason, severity, conditions of injury. The complex soft tissue defect in the foot and ankle can be treated by different types of ALT flap.

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References

1. D. A. Hidalgo và W. W. Shaw. Reconstruction of foot injuries. Clin Plast Surg. 1986; 13(4), 663-680.
2. Hallock GG. Foot and ankle skin coverage: soft tissue coverage after revisional foot and ankle surgery. Clin Podiatr Med Surg. 2017; 34(3): 389 – 398.
3. Saint-Cyr M, Schaverien M, Wong C, Nagarkar P, Arbique G, et al. (2009) The
extended anterolateral thigh flap: Anatomical basis and clinical experience. Plast
Reconstr Surg 123:1245–1255.
4. Nguyễn Đình quân. Nghiên cứu đặc điểm lâm sàng và phân loại các tổn khuyết phần mềm vùng cổ, bàn chân tại bệnh viên Đại học Y Hà Nội từ 10/2016 - 7/2018. Tạp chí Y học thực hành (1080), số 9/2018.
5. F. Santanelli di Pompeo, P. Pugliese, M. Sorotos. Microvascular reconstruction of complex foot defects, a new anatomo-functional classification. Injury, 46(8), 1656-1663.
6. BanzetP. và ServantJ.M. Pertes de substance de la cheville et du pied. Chirurgie plastique reconstructrice et esthestique, médecine - Sciences Flammarion, Pari. 1994; 38, 521 – 546.
7. Lee ZH, Abdou SA, Ramly EP, et al. Larger free flap size is associated with increased complications in lower extremity trauma reconstruction. Microsurgery. 2020;40(4):473-478. doi:10.1002/micr.30556.
8. Hong JP, Kim EK. Sole reconstruction using anterolateral thigh perforator free flaps. Plast Reconstr Surg. 2007;119(1):186-193. doi:10.1097/01.prs.0000244856.98170.9c.
9. Son TT, Dung PTV, Thuy TTH, Chien VH, Phuc LH, Huy LA. One-stage reconstruction of the massive overlying skin and Achilles tendon defects using a free chimeric anterolateral thigh flap with fascia lata. Microsurgery. 2022;42(7):659-667. doi:10.1002/micr.30931.