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Revista Cubana de Ortopedia y Traumatología
Print version ISSN 0864-215XOn-line version ISSN 1561-3100
Abstract
MATA CUEVAS, Roberto; MORALES PINEIRO, Sergio and MARTINEZ ESTUPINAN, Lázaro. Reverse Sural Flap plus Free Graft in Heel and Ankle Reconstruction. Rev Cubana Ortop Traumatol [online]. 2021, vol.35, n.2, e345. Epub Dec 01, 2021. ISSN 0864-215X.
Introduction:
Traumatic injuries with loss of skin coverage of the ankle and foot region constitute great challenge for the orthopedic surgeon due to the exposure and destruction of noble tissues, difficult to solve because this area has little adipose tissue, multiple tendons , little muscle volume, several bony prominences and not very elastic skin.
Objective:
To establish that the reverse flow sural flap is a good alternative to treat closed comminuted fracture of the tibia with massive skin loss of the entire circumference of the ankle and calcaneus, including the plantar face fat pad.
Case report:
We report the case of a 24-year-old patient who suffered a traffic accident with a comminuted and closed fracture of the right tibia, as well as a flap-type wound that exposed the calcaneus and the ankle region. After placing RALCA external fixator to fix the fracture, a reverse flow island sural flap was made to cover the defect on the plantar and posterior aspect of the calcaneus, and a free skin graft taken from the anterior external aspect of the ipsilateral thigh. These procedures were performed in two surgical stages.
Conclusions:
The reverse flow sural flap proved to be one of the best alternatives for the coverage of injuries from the middle third of the leg to the foot, which is why it should be known not only by plastic surgeons, but also by orthopedic surgeons and traumatologists and to incorporate this alternative into their therapeutic arsenal.
Keywords : surgical flaps; fractures; surgery; orthopedic procedures; methods.