Archives of Plastic Surgery

  • 제50권5호
  • /
  • Pages.523-528
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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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Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap

  • Lan Sook Chang (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Dae Kwan Kim (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Ji Ah Park (Design Laboratory of the Technology Commercialization Center, Industry-University Cooperation Foundation of Hanyang University) ;
  • Kyu Tae Hwang (Department of Orthopaedic Surgery, College of Medicine, Hanyang University) ;
  • Youn Hwan Kim (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
  • 투고 : 2023.01.02
  • 심사 : 2023.06.14
  • 발행 : 2023.09.15
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초록

The Gustilo IIIB tibiofibular fractures often result in long bone loss and extensive soft tissue defects. Reconstruction of these complex wounds is very challenging, especially when it includes long bone grafts, because the donor site is limited. We describe our experience using a set of chimeric ipsilateral vascularized fibula grafts with a thoracodorsal artery perforator free flap to reconstruct the traumatic tibia defects. A 66-year-old male suffered a severe comminuted tibia fracture and segmented fibula fracture with large soft tissue defects as a result of a traffic accident. He also had an open calcaneal fracture with soft tissue defects on the ipsilateral side. All the main vessels of the lower extremity were intact, and the cortical bone defect of the tibia was almost as large as the fractured fibula segment. We used an ipsilateral vascularized fibula graft to reconstruct the tibia and a thoracodorsal artery perforator flap to resurface the soft tissue, using the distal ends of peroneal vessels as named into sequential chimeric flaps. After 3 weeks, the calcaneal defect was reconstructed with second thoracodorsal artery perforator free flap. Reconstruction was successful and allowed rapid rehabilitation because of reduced donor site morbidity.

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참고문헌

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