Extensor digitorum brevis muscle flap for lower extremity coverage in a context of posttraumatic sepsis - 20/05/21
, Damien Feuvrier a, Édouard Woussen a, Julien Fageot a, Pauline Sergent a, Grégoire Leclerc a, Laurent Obert a, b, Isabelle Pluvy a, b
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
Articolo gratuito.
Si connetta per beneficiarne
Abstract |
Introduction |
Traumatic injuries to the distal quarter of the leg present a significant risk of skin necrosis and exposure of the underlying fracture site or the osteosynthesis material that often result in bone and joint infection. In the case of small or medium-sized bone exposure, local muscles may be one of the best options for lower extremity coverage. We describe our experience using the extensor digitorum brevis muscle flap in a context of posttraumatic bone and joint infection in fourteen patients. Our main objective was to assess the outcomes and the donor-site morbidity of the extensor digitorum brevis muscle flap.
Materials and methods |
A single-center retrospective study in a French reference center for bone and joint infection from 2014 to 2018 reviewed cases of traumatic injuries with skin complications and bone and joint infection that required an extensor digitorum brevis muscle flap coverage. Fourteen patients were evaluated for early and late complications, 11 men and three women with a mean age of 51.4±17.72 (19–71) years. Seven of these were open fractures and nine cases were pilon fractures. Donor-site morbidity was assessed in nine patients.
Results |
Early flap complications included two cases (14.2%) of hematoma, one case (7.1%) of partial necrosis and four cases (28.5%) of donor-site dehiscence. Late complications caused by persistent infection were found in two patients (14.2%), with one case (7.1%) of chronic osteoarthritis and one case (7.1%) of septic pseudarthrosis. From a functional and cosmetic point of view, eight patients (89%) were satisfied, to very satisfied.
Conclusion |
Experience and a multidisciplinary approach are keys in providing an optimal treatment strategy for complex cases of bone and joint infection. The extensor digitorum brevis muscle is a reliable flap for small defects with underlying infection. Being made up of muscle tissue, this flap offers good resistance to infection and enables satisfactory distribution of antibiotics.
Level of evidence |
IV.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Extensor digitorum brevis flap, Osteoarthritis infection, Lower extremity, Pedicle flap, Muscle flap, Posttraumatic context
Mappa
| ☆ | Oral presentation at the 4th National CRIOAC [Centre de référence des infections ostéo-articulaires complexes (French reference centers for complex bone and joint infections)] Conference. |
| ☆☆ | Oral presentation at the 64th National SOFCPRE [Société française de chirurgie plastique, reconstructive et esthétique (French society of plastic, reconstructive and cosmetic surgery)] Conference. |
Vol 107 - N° 4
Articolo 102901- giugno 2021 Ritorno al numero
Articolo precedente
- Above–the–knee amputation versus knee arthrodesis for revision of infected total knee arthroplasty: Recurrent infection rates and functional outcomes of 43 patients at a mean follow-up of 6.7 years
- Teddy Trouillez, Philippe Alexandre Faure, Pierre Martinot, Henri Migaud, Eric Senneville, Gilles Pasquier, Julien Dartus, Sophie Putman
- The application of topical vancomycin powder for the prevention of surgical site infections in primary total hip and knee arthroplasty: A meta-analysis
- Zhi Peng, Xiaoying Lin, Xiaolin Kuang, Zhaowei Teng, Sheng Lu
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.