Archives of Plastic Surgery

  • 제50권5호
  • /
  • Pages.501-506
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  • 2023
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Osteocutaneous Turn-Up Fillet Flaps: A Spare-Parts Orthoplastic Surgery Option for a Functional Posttraumatic Below-Knee Amputation

  • Harry Burton (London Reconstructive Microsurgery Unit, Emergency Care and Trauma Division, Department of Plastic Surgery, The Royal London Hospital) ;
  • Alexios Dimitrios Iliadis (Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital) ;
  • Neil Jones (Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital) ;
  • Aaron Saini (Trauma and Limb Reconstruction Unit, Department of Trauma and Orthopaedics, King's College Hospital Foundation Trust) ;
  • Nicola Bystrzonowski (Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital) ;
  • Alexandros Vris (Limb Reconstruction and Bone Infection Unit, Emergency Care and Trauma Division, Department of Trauma and Orthopaedics, The Royal London Hospital) ;
  • Georgios Pafitanis (London Reconstructive Microsurgery Unit, Emergency Care and Trauma Division, Department of Plastic Surgery, The Royal London Hospital)
  • 투고 : 2022.08.18
  • 심사 : 2023.02.12
  • 발행 : 2023.09.15
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초록

This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of "spare parts" in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed "lowering the level of the amputation" from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying "spare-parts" surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

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참고문헌

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