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Exposed Distal Tibia Coverage by Reversed Soleus Muscle Flap: Our Experiences

Reconstruction of the exposed lower third tibia and ankle region remains a difficult task and a challenge for reconstructive surgeons. Microsurgical flaps have been the method of choice for this reconstruction, but in our hospital, we do not have equipment or a microsurgical-trained team for this ty...

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Autores principales: Nazneen, Dr. Afroza, Sarkar, Dr. Asim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514381/
https://www.ncbi.nlm.nih.gov/pubmed/37745009
http://dx.doi.org/10.1016/j.jpra.2023.08.005
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author Nazneen, Dr. Afroza
Sarkar, Dr. Asim
author_facet Nazneen, Dr. Afroza
Sarkar, Dr. Asim
author_sort Nazneen, Dr. Afroza
collection PubMed
description Reconstruction of the exposed lower third tibia and ankle region remains a difficult task and a challenge for reconstructive surgeons. Microsurgical flaps have been the method of choice for this reconstruction, but in our hospital, we do not have equipment or a microsurgical-trained team for this type of procedure. Moreover, free muscle flaps have more risk of failure and sometimes the patient's clinical condition does not allow a more complex surgery in some cases. Local muscle flaps are preferred in these situations. METHODOLOGY: This study was carried out in the Burn and Plastic Surgery Department, Rajshahi Medical College Hospital, Rajshahi from July 2015 to December 2021 on 100 patients ( 89 males and 11 females with ages ranging between 21 and 62 years). Patients with tibial defects in the distal third of the tibia which need soft tissue coverage were selected. RESULTS: Our study shows that reversed medial hemisoleus muscle flap had an excellent outcome with short surgical duration, easy implementation, excellent resolution, and low morbidity of the donor area. Moreover, preservation of the lateral portion is suitable for plantar flexion showing a long arc of rotation. CONCLUSION: Medial hemisoleus muscle flap is a reliable option for the reconstruction of soft tissue defects with the exposed bone of the distal leg based on perforators of the posterior tibial artery. Careful flap dissection with preservation of as many perforators as possible is the key to success.
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spelling pubmed-105143812023-09-23 Exposed Distal Tibia Coverage by Reversed Soleus Muscle Flap: Our Experiences Nazneen, Dr. Afroza Sarkar, Dr. Asim JPRAS Open Original Article Reconstruction of the exposed lower third tibia and ankle region remains a difficult task and a challenge for reconstructive surgeons. Microsurgical flaps have been the method of choice for this reconstruction, but in our hospital, we do not have equipment or a microsurgical-trained team for this type of procedure. Moreover, free muscle flaps have more risk of failure and sometimes the patient's clinical condition does not allow a more complex surgery in some cases. Local muscle flaps are preferred in these situations. METHODOLOGY: This study was carried out in the Burn and Plastic Surgery Department, Rajshahi Medical College Hospital, Rajshahi from July 2015 to December 2021 on 100 patients ( 89 males and 11 females with ages ranging between 21 and 62 years). Patients with tibial defects in the distal third of the tibia which need soft tissue coverage were selected. RESULTS: Our study shows that reversed medial hemisoleus muscle flap had an excellent outcome with short surgical duration, easy implementation, excellent resolution, and low morbidity of the donor area. Moreover, preservation of the lateral portion is suitable for plantar flexion showing a long arc of rotation. CONCLUSION: Medial hemisoleus muscle flap is a reliable option for the reconstruction of soft tissue defects with the exposed bone of the distal leg based on perforators of the posterior tibial artery. Careful flap dissection with preservation of as many perforators as possible is the key to success. Elsevier 2023-08-27 /pmc/articles/PMC10514381/ /pubmed/37745009 http://dx.doi.org/10.1016/j.jpra.2023.08.005 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Nazneen, Dr. Afroza
Sarkar, Dr. Asim
Exposed Distal Tibia Coverage by Reversed Soleus Muscle Flap: Our Experiences
title Exposed Distal Tibia Coverage by Reversed Soleus Muscle Flap: Our Experiences
title_full Exposed Distal Tibia Coverage by Reversed Soleus Muscle Flap: Our Experiences
title_fullStr Exposed Distal Tibia Coverage by Reversed Soleus Muscle Flap: Our Experiences
title_full_unstemmed Exposed Distal Tibia Coverage by Reversed Soleus Muscle Flap: Our Experiences
title_short Exposed Distal Tibia Coverage by Reversed Soleus Muscle Flap: Our Experiences
title_sort exposed distal tibia coverage by reversed soleus muscle flap: our experiences
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514381/
https://www.ncbi.nlm.nih.gov/pubmed/37745009
http://dx.doi.org/10.1016/j.jpra.2023.08.005
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