Objective: To sum up experiences and lessons about management of soft-tissue reconstruction in open tibial fracture over a 6-year period. Methods: Twenty-two flap reconstructions were performed to treat soft-tissue de...Objective: To sum up experiences and lessons about management of soft-tissue reconstruction in open tibial fracture over a 6-year period. Methods: Twenty-two flap reconstructions were performed to treat soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively after follow up of 12-61 months. Results: The size of the flap ranged from 6.6 cm 2 to 28.18 cm 2 and the rate of flap failure was 13.6%. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series. Conclusions: For soft tissue defect of delayed open tibial fracture Type IIIB, flap reconstruction is still an optimal option. The experiences we obtained are ① to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; ② to select a unilateral external fixation to provide convenience for any secondary manipulation; and ③ to use serial debridement to diminish flap failure.展开更多
文摘Objective: To sum up experiences and lessons about management of soft-tissue reconstruction in open tibial fracture over a 6-year period. Methods: Twenty-two flap reconstructions were performed to treat soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively after follow up of 12-61 months. Results: The size of the flap ranged from 6.6 cm 2 to 28.18 cm 2 and the rate of flap failure was 13.6%. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series. Conclusions: For soft tissue defect of delayed open tibial fracture Type IIIB, flap reconstruction is still an optimal option. The experiences we obtained are ① to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; ② to select a unilateral external fixation to provide convenience for any secondary manipulation; and ③ to use serial debridement to diminish flap failure.
