비골-가자미근 유리피판술을 이용한 족부의 골 및 연부 조직 결손 재건

Fibula-Hemisoleus Osteomusculocutaneous Free Flap for Foot Reconstruction

  • 문혜영 (연세대학교 의과대학 성형외과학교실) ;
  • 노태석 (연세대학교 의과대학 성형외과학교실) ;
  • 이혜경 (마산삼성의료원) ;
  • 탁관철 (연세대학교 의과대학 성형외과학교실)
  • Mun, Hye-Young (Department of Plastic and Reconstructive Surgery, Yondong Severance Hospital, Yonsei University College of Medicine) ;
  • Roh, Tai-Suk (Department of Plastic and Reconstructive Surgery, Yondong Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Hye-Kyung (Department of Plastic and Reconstructive Surgery, Masan Samsung Hospital) ;
  • Tark, Kwan-Chul (Department of Plastic and Reconstructive Surgery, Yondong Severance Hospital, Yonsei University College of Medicine)
  • 발행 : 2001.05.31

초록

The injury on the dorsum of foot is usually manifested in the defect of bone and soft tissue, so its reconstruction requires composite tissue. Free flap satisfies this defect but its indication is determined by the defect size, recipient status and so on. Iliac crest bone and fibular bone are useful bone flap but in more than 8cm defect, fibular flap is more useful. The drawback of fibular free flap is the absence of soft-tissue coverage, so another local flap and myocutaneous flap must be added. Fibula-hemisoleus ostemusculocutaneous free flap has been used for the reconstruction of upper and lower extremity. Its advantages are one stage operation, one donor site and the flexibility of the reconstruction with the use of muscle, bone, and skin. This flap has never been reported for the reconstruction of dorsum of foot. In our case, 20-year-old woman was referred with the 17 cm defect of 1st metatarsal bone and $16{\times}8cm$ sized soft tissue loss on the dorsum of the right foot. We reconstructed successfully the dorsum of foot with fibula-hemisoleus osteomusculocutaneous free flap and the patient can walk without crutches after 6 monthes.

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