Flap surgery in treatment of patients with pathology of ankle

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Abstract

Objective: to determine the capabilities and perspectives of flap surgery in treatment of patients with traumas and diseases of ankle joint region. Material and methods. The results of surgical treatment of 88 such patients. All the patients were treated in the Vreden Russian Research Institute of Traumatology and Orthopedics within the period from 2000 to 2011. All the patients had pedicled flap transfer (46 cases) or free tissue transfer (45 cases). 11 patients had additional need in other open orthopedic operations of ankle joint. Besides this, scientific works dealing with the studied problem have been analyzed. Results and conclusions. It has been stated that flap surgery is predominantly used as the only and exhaustive method of treatment of such patients (87,5%). In these situations pedicled flap transfer and free tissue transfer tend to be used in comparatively equal quantities. Flap surgery is now seldom used as a component of complex surgical treatment. It is used only in some cases of bone reconstruction of distal tibia by Ilizarov bone transport, in some cases of tumors of ankle joint as well as in some cases of local infectious complications after internal fixation and total ankle arthroplasty. Patients with the pathology of this kind have a high need in free tissue transfer (from 66,7% to 83,3%). Progressing technology of total ankle arthroplasty will contribute to the frequency of use of flap surgery for patients with pathology of ankle joint.

About the authors

D. I. Kutyanov

Vreden Russian Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: diku77@mail.ru
Russian Federation

L. A. Rodomanova

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: rodomanovaliubov@rambler.ru
Russian Federation

References

  1. Белоусов А.Е., Шумило А.В. Лечение больных с дефектами большеберцовой кости. В кн.: Пластическая, реконструктивная и эстетическая хирургия. СПб.: Гиппократ; 1998. С. 528-552.
  2. Емельянов В.Г., Стоянов А.В., Машков В.М., Белянин О.Л., Денисов А.Г., Аболин А.Б., Хромов А.А., Львов В.А. Объективизация степени тяжести посттравматического состояния голеностопного сустава. Травматология и ортопедия России. 2003; (3): 14-17.
  3. Козлов И.В. Пластическое замещение остеомиелитических дефектов голени и стопы лоскутами с осевым типом кровоснабжения [дис. . канд. мед. наук]. СПб.; 2007. 185 с.
  4. Котельников Г.П., Мирошниченко В.Ф. Закрытые травмы конечностей. М.: ГЭОТАР-Медиа; 2009. 496 с.
  5. Пахомов И.А. Осложнения эндопротезирования голеностопного сустава. Политравма. 2011; (4): 17-22.
  6. Родоманова Л.А., Кочиш А.Ю. Реконструктивные микрохирургические операции при травмах конечностей (руководство для врачей). СПб.: РНИИТО; 2012. 116 с.
  7. Соломин Л.Н. Основы чрескостного остеосинтеза аппаратом Г.А.Илизарова. СПб.: МОРСАР АВ; 2005. 544 с.
  8. Стоянов А.В. Хирургическое лечение больных с застарелыми пронационными подвывихами в голеностопном суставе [дис. ... канд. мед. наук]. СПб.; 2005. 145 с.
  9. Стоянов А.В., Емельянов В.Г., Корышков Н.А., Плиев Д.Г., Привалов А.М. Имплантация эндопротеза голеностопного сустава HINTEGRA: мед. технология. СПб.; 2010. 22 с.
  10. Тихилов Р.М., Корышков Н.А., Емельянов В.Г., Стоянов А.В., Журавлев А.В., Привалов А.М. Опыт эндопротезирования голеностопного сустава в российском научно-исследовательском институте травматологии и ортопедии им. Р.Р.Вредена. Вестник травматологии и ортопедии им. Н.Н.Приорова. 2009; (3): 56-60.
  11. Arai K., Toh S., Tsubo K., Nishikawa S., Narita S., Miura H. Complications of vascularized fibula graft for reconstruction of long bones. Plast. Reconstr. Surg. 2002; 109(7): 2301-2306.
  12. Buechel F.F., Pappas M.J. Twenty-year evaluation of cementless mobile-bearing total ankle replacements. Clin. Orthop. 2004; (424): 19-26.
  13. Claridge R.J., Kitaoka H.B. The history of ankle replacement arthroplasty. In: Morrey B.F., Berry D.J. (ed.): Joint replacement arthroplasty. Vol. 2, Chapter 101. Philadelphia, 2011. p. 1059-1082.
  14. Gill L.H. Avascular necrosis of the talus secondary to trauma, dis — ease, drugs, and treatment. Foot Ankle Clin. 1999; (4): 431-446.
  15. Mann J.A., Mann R.A., Jorton E. S.T.A.R.(TM) ankle: long-term results. Foot Ankle Int. 2011; (32): 473-484.
  16. Park S., Lee T.J. Strategic considerations on the configuration of free flaps and their vascular pedicles combined with Ilizarov distraction in the lower extremity. Plast. Reconstr. Surg. 2000; 105(5): 1680-1686.
  17. Ryssman D.B., Turner III N.S. Alternative procedures: debridement, osteotomies, distraction, arthroplasty and arhtrodesis. In: Morrey B.F., Berry D.J. (ed.): Joint replacement arthroplasty, Vol. 2. Chapter 105. Philadelphia, 2011. p. 1119-1129.
  18. Whalen J., Kitaoka H.B. Complications and salvage of failed total ankle arthroplasty. In: Morrey B.F., Berry D.J. (ed.): Joint replacement arthroplasty, Vol. 2. Chapter 104. — Philadelphia, 2011. — p. 1110-1180.
  19. Whalen J.L., Spelsberg S.C., Murray P.M. Wound breakdown after total ankle arthroplasty. Foot Ankle International. 2010; (31): 301-305.

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