Technical successes and functional failures after free tissue transfer to the tibia
✍ Scribed by Kevin P. Yakuboff; Dr. Peter J. Stern; Henry W. Neale
- Publisher
- John Wiley and Sons
- Year
- 1990
- Tongue
- English
- Weight
- 367 KB
- Volume
- 11
- Category
- Article
- ISSN
- 0738-1085
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
A retrospective study evaluated functional outcome in 59 patients with 61 successful free tissue transfers performed after open tibial fractures. Twentyone patients had transfers done within 7 days, 13 between 7 and 21 days, and 25 were done greater than 3 weeks after injury. All 59 patients had Type III injuries as classified by Gustilo and Anderson. Nineteen patients (32%) were identified as late functional failures. Each of these patients underwent as average of 10 procedures. In this group chronic osteomyelitis was noted in 13 of 19 patients and chronic venous insufficiency with skin ulceration in 9 of 19 patients. Fracture nonunion was seen in 8 of 19. Degenerative joint problems and foot deformities were identified in 7 or 19 patients. Seven patients (12%) ultimately required below‐knee amputation. Functional failure did not correlate with the timing of flap application, but rather with the severity of the initial injury. Free tissue transfer is not a panacea. It is but one step in the overall reconstruction of complex tibial wounds.