Abstract
BackgroundSkin necrosis and implant exposure most often appear at the corner of Extensile Lateral Approach for open reduction and internal fixation (ORIF) for displaced intra-articular fracture of the calcaneus. Flap transfer is often used for coverage of this implant exposure. We introduced a new simple local random pattern flap to cover the implant exposure.MethodsFrom March 2017 to March 2020, 12 patients with implant exposure after ORIF for displaced intra-articular fracture of the calcaneus were treated with this procedure. The sizes of the defects ranged from 2 × 2 cm2 to 5 × 2 cm2. A local random pattern flap was designed according to the defect size. The lower edge of the flap was along with the wound upper edge and extended distally. The upper horizontal incision of the flap was made at the lateral malleolus level with a length of 5–7 cm depending on the wound defect. Then the random pattern flap was elevated and transferred to cover the defect area.ResultsThe mean follow-up duration was 6.3 months (ranging 4–13 months). All 12 flaps were uneventfully healed and all patients were able to wear shoes, and no debulking procedures were required.ConclusionThe local random pattern flap could be a choice for surgeons when implant exposure at the corner of Extensile Lateral Approach to the Calcaneus occurs.
Highlights
Calcaneal fracture comprises 1–2% of all fractures which is the most frequently fractured of all the tarsal bones [1]. 71% of calcaneal fractures are intra-articular calcaneal fractures, which are the most challenging types for treatment [2]
The management of Displaced intraarticular calcaneal fractures can be divided into four categories: non-operative management; open reduction and internal fixation (ORIF); minimally invasive reduction
We reported a local random pattern flap for coverage of the skin necrotic area with implant exposure
Summary
Calcaneal fracture comprises 1–2% of all fractures which is the most frequently fractured of all the tarsal bones [1]. 71% of calcaneal fractures are intra-articular calcaneal fractures, which are the most challenging types for treatment [2]. The management of Displaced intraarticular calcaneal fractures can be divided into four categories: non-operative management; open reduction and internal fixation (ORIF); minimally invasive reduction. Liu et al BMC Musculoskeletal Disorders (2021) 22:567 the Calcaneus is the most likely site of wound healing complications, with skin necrosis. Mueller et al reported that they used the musculocutaneous sural artery flap for coverage of implant exposure after calcaneal fracture [10]. A free flap is used to cover calcaneal soft-tissue defects [11], but the procedure is timeconsuming and technically demanding. We used a local random skin flap for soft tissue coverage of implant exposure after calcaneal fracture procedures. Skin necrosis and implant exposure most often appear at the corner of Extensile Lateral Approach for open reduction and internal fixation (ORIF) for displaced intra-articular fracture of the calcaneus. We introduced a new simple local random pattern flap to cover the implant exposure
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