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Journal of the Korean Society for Surgery of the Hand 2007;16(2):93-99.
Published online November 30, 2007.
One-stage Reverse Lateral Supramalleolar Adipofascial flap for Soft Tissue Reconstruction of the Foot and Ankle Joint
Boo-Kyung Kwon, M.D., Duke-Whan Chung, M.D., Jae-Hoon Lee, M.D., Il-Hoen Choi, M.D., Jong-Hoon Song, M.D., Sung-Won Lee, M.D.
Department of Orthopedic Surgery, Kyung Hee University, Seoul, Korea. ljhortho@yahoo.or.kr
족부 및 족관절 주위 연부조직 재건을 위한 일단계 역행성 외측 과상부 지방근막 피판술
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Purpose: To report the clinical results and efficacies of one stage reverse lateral supramalleolar adipofascial flap for soft tissue reconstruction of the foot and ankle joint.
Material and Methods: We performed 5 cases of one stage reverse lateral supramalleolar adipofascial flap from Jan 2005 to Sept 2005. All patients were males and mean age was 50(36~59) years old. The causes of soft tissue defects were 1 diabetic foot, 2 crushing injuries of the foot, 1 open fracture of the calcaneus, and 1 chronic osteomyelitis of the medial cuneiform bone. Average size of the flap was 3.6(3~4)×4.6(4~6) cm. All flaps were harvested as adipofascial flap and were performed with the split-thickness skin grafts (STSG) above the flaps simultaneously.
Results: All flap survived completely and good taking of STSG on the flap was achieved in all cases. There were no venous congestion and marginal necrosis of the flap. In diabetic foot case, wound was healed at 4 weeks after surgery due to wound infection. There was no contracture on the grafted sites. Ankle and toe motion were not restricted at last follow up. All patients did not have difficulty in wearing shoes.
Conclusion: The reverse lateral supramalleolar adipofascial flap and STSG offers a valuable option for repair of exposure of the tendon and bone around the ankle and foot. Also one stage procedure with STSG can give more advantages than second stage with FTSG, such as good and fast take-up, early ambulation and physical therapy, and good functional result.
Key Words: Ankle and foot, Soft tissue reconstruction, One stage lateral supramalleolar adipofascial flap.

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