Tissue flap transplantation plus bone transportation for repair of massive multi-tissue defects at the leg

Abstract

Objective To report the clinical effects of treating massive multi-tissue defects at the leg with tissue flap transportation and bone transportation.Methods The clinical data was analyzed retrospectively of 92 patients who had been treated from January 2005 to December 2011 for massive soft tissue and large segmental bone defects at the leg.They were 71 males and 21 females,with a mean age of 38.3 years (range,19 to 56 years).They were treated by herbal dressing on wounds before operation.At the subacute stage,massive skin and large segmental bone defects were treated with skin flap transplantation plus bone transportation and damaged muscular function and large segmental bone defects were managed with musculocutaneous flap transplantation plus bone transportation.After operation,traditional Chinese medication was administered for anticoagulation in all cases.Results All operations were completed successfully without infection.Vascular anastomoses were conducted in free transplantation of 106 pieces of tissue.All transplanted tissues survived except for tip necrosis of one skin flap.On average,each patient received 2.6 operations and had an average duration of 256 days for treatment.The follow-up periods for all the patients ranged from 10 to 48 months (mean,24.6 months).According to Paley criteria,53 cases were rated as excellent,26 as good,9 as fair,and 4 as poor,giving a good to excellent rate of 85.9％.Conclusion As tissue flap transplantation plus bone transportation can restore the function of the leg as much as possible,it is an effective treatment of massive multi-tissue defects at the leg. Key words: Tissue transplantation; Soft tissue defect; Reconstructive surgical procedures; Bone transportation