Timing of Secondary Bone Graft after Microvascular Flap Coverage: Does the Anterolateral Thigh Perforator Flap Have Advantages Over the Muscle Flap?

Abstract

Bone graft is commonly used to fill tibial bone gaps after trauma, cancer resection, and chronic bone infection. The vascularized bone graft is preferred for defects longer then 6 cm, whereas defects less than 6 cm are successfully reconstructed with bone grafts. In order to ensure graft survival, well-vascularized soft-tissue coverage becomes essential. A two-staged method may be applied for bone defects less than 6 cm, accompanied by soft-tissue defects – initial coverage of soft tissue followed by the bone graft procedure. Various flaps can be used to cover soft-tissue defects, from muscle to perforator flaps. Secondary bone graft procedures may follow from 3 weeks after coverage. The purpose of this paper was to compare the efficacy of both perforator and muscle flap coverage prior to secondary bone graft procedures.