Abstract
Despite various therapy options, the prophylactic and symptomatic treatment of recurrent
ulcerations in the diabetic foot are still challenging. We report the application
of a free vascularized medial femoral condyle flap to prevent the recurrence of pressure
ulcer in a patient with diabetic foot syndrome. Our patient had type 2 diabetes and
presented with pressure ulcers and osteomyelitis of metatarsal heads 2 and 3 after
a great toe amputation. We chose to use a medial femoral condyle flap as a damper
in the area of the metatarsal heads because of the relatively young age and good vascularity
of our patient. We shaped the graft like a ski to distribute the pressure and prevent
perforation of the plantar skin. Good results were achieved for wound healing, pain
reduction, and improvement of gait. No pressure ulceration had recurred after a 3-year
follow-up period. The versatility of the osteomyocutaneous graft from the medial femoral
condyle is an important reconstructive tool for addressing major surgical problems.
We present the first use of a medial femoral condyle flap in the treatment of a pressure
ulcer in a diabetic foot. In selected patients, our method could prevent premature
and extended amputations, thereby providing good improvement in patients' quality
of life.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: May 24, 2018
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.
