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1. The repair of the lower leg, ankle and foot soft tissue defects H.S. Shu M.D. B.T. Ma M.D.
Dept.of Orthopaedic Trauma
TianJin Hospital P.R.China
2. For a variety of reasons, mainly anatomical, the skin and soft tissue defects in the lower leg and foot remain a challenging problem for orthopaedic and reconstructive surgeons.
4. Simple skin grafts, local random flaps, microvascular flaps, etc., has been used to tackle this difficult problem.
5. Over the past 15 years , Most popular flaps are the neurocutaneous island flap(skin island flaps supplied by the vascular axis of the sensitive superficial nerves)
6. Infected and nonunion fracture
9. Full weight bearing post op
10. Before After
13. Sural Neurocutaneous Island Flap
14. Drawing of the procedure
15. 7 year old boy,heel defect 14×11cm2
17. Post-Op 6 months, normal gait, no limp. The flap has protective sensation
19. 10 year-old-boy part of lateral malleolus and peroneus longus and brevis defect
22. Post-op 18 months,good function, no pes varus
23. 28-years-old man
36. Chronic calcaneal osteomyelitis
38. Saphanous neurocutaneous island flap
39. Drawing of the procedure
40. Varicose foot
41. 1.5cm skin bridge on the pedicle?
42. Flap completely survived
46. Post op Distal tibia Gustilo IIIC open fracture
49. One flap covered two wounds
50. Case 14
52. Supra-malleolar flap
53. Case 15
55. The first metatarsal head coverage
56. Case 16
60. Thank You