Stage I repair of skin and soft tissue defects using lateral femoral perforator free flap in pilon fracture surgery

Abstract

Background: To investigate the clinical effects of stage I repair of skin and soft tissue defects using lateral femoral perforator free flap in pilon fracture surgery. Methods: Fifteen cases of pilon fractures were selected from our hospital between April 2013 and January 2017. There were 8 cases of 43-C1, 4 cases of 43-C2 and 3 cases of 43-C3 fractures, as defined by the Miller AO classification. In all cases, severe contusion of skin and soft tissue around the fracture, skin darkening and necrosis, and tissue edema during surgery, led to difficult closure of incision. The skin and soft tissue defects were repaired at stage I by ipsilateral lateral femoral perforator free flap. Results: Venous crisis occurred in one case, while the other 14 cases survived. During the 6–18 months of follow-up, the function of ankles was satisfactory and the wearing of shoes was not affected by the abnormal foot. The flap color and texture were normal and the protective sensation of the flap recovered. Only a linear scar remained at the donor site and no muscle adhesion occurred. Conclusions: Stage I repair of skin and soft tissue defects using lateral femoral perforator free flap in pilon fracture surgery apparently decreased postoperative infection and protected the blood supply around the fracture. Hence, it was an effective repair method.