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The repair of the lower leg, ankle and foot soft tissue defects

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The repair of the lower leg, ankle and foot soft tissue defects

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    1. The repair of the lower leg, ankle and foot soft tissue defects H.S. Shu M.D. B.T. Ma M.D. Dept.of Orthopaedic Trauma TianJin Hospital P.R.China

    2. For a variety of reasons, mainly anatomical, the skin and soft tissue defects in the lower leg and foot remain a challenging problem for orthopaedic and reconstructive surgeons.

    4. Simple skin grafts, local random flaps, microvascular flaps, etc., has been used to tackle this difficult problem.

    5. Over the past 15 years , Most popular flaps are the neurocutaneous island flap(skin island flaps supplied by the vascular axis of the sensitive superficial nerves)

    6. Infected and nonunion fracture

    7. Debridement+Ilizarov+Flap

    9. Full weight bearing post op

    10. Before After

    13. Sural Neurocutaneous Island Flap

    14. Drawing of the procedure

    15. 7 year old boy,heel defect 14×11cm2

    17. Post-Op 6 months, normal gait, no limp. The flap has protective sensation

    19. 10 year-old-boy part of lateral malleolus and peroneus longus and brevis defect

    22. Post-op 18 months,good function, no pes varus

    23. 28-years-old man

    36. Chronic calcaneal osteomyelitis

    38. Saphanous neurocutaneous island flap

    39. Drawing of the procedure

    40. Varicose foot

    41. 1.5cm skin bridge on the pedicle?

    42. Flap completely survived

    46. Post op Distal tibia Gustilo IIIC open fracture

    49. One flap covered two wounds

    50. Case 14

    52. Supra-malleolar flap

    53. Case 15

    55. The first metatarsal head coverage

    56. Case 16

    60. Thank You

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