Abstract
Currently, there is no ideal method defined in the repair of complex lateral malleolar
defects, and the existing methods (i.e., bone repair, soft tissue or free flap closure)
are far from producing functional results in terms of the ultimate recovery of ankle
movements. Herein, an operative technique for soft tissue, ligamentous, and osseous
reconstruction of fibular defect, using a free vascularized serratus anterior osteomusculocutaneous
flap for reconstruction of a fibular deficit and the sixth costa for soft tissue coverage,
was described in relation to tissue coverage and functional reconstruction outcome
in a 31-year-old male patient with soft tissue and distal fibula defects in the lateral
malleolus region caused by a traffic accident. Ankle movement was regained to almost
full extent. No complications requiring further intervention was encountered in the
donor site or ankle. In conclusion, the described operative technique enabled the
repair of functional ligaments of the ankle joint in addition to repair of the soft
tissue, lateral malleolus bone and skin defects in one session without the need for
further additional operative intervention. Hence, the use of serratus osteomusculocutaneous
free flap as a lateral malleolar reconstruction method seems to enable not only the
tissue coverage but also to assist with functional reconstruction.
Level of Clinical Evidence
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A novel flap to repair medial and lateral malleol defects anterior tibal artery perforator-based adipofascial flap.Ann Plast Surg. 2006; 57: 396-401
- Free composite serratus anterior muscle-rib flap for reconstruction severely damaged foot.Ann Plast Surg. 1988; 20: 167-172
- Medial and lateral malleolar perforator flaps for repair of defects around the ankle.Ann Plast Surg. 2003; 51: 579-583
- Repair of a lateral malleolus defect with a composite pedicled second metatarsal flap.J Int Med Res. 2018; 46: 5291-5296
- One-stage repair of compound legdefects with free, revascularized flaps of groin skin and iliacbone.Plast Reconstr Surg. 1978; 61: 494-506
- Arterial vascularization ofthe proximal epiphysis and the diaphysis of the fibula.Int J Microsug. 1980; 2: 49-55
- Osteoarthritis of the foot (in Japanese with English abstract).MB Orthop. 1995; 8: 63-72
- Ceramic artificial talus as the initial treatment for comminuted talar fractures.Foot Ankle Int. 2020; 41: 79-83
- Osseous healing in foot and ankle surgery with autograft, allograft and other orthobiologics.Orthop Clin North Am. 2017; 48: 359-369
- Reconstruction of the form and function of lateral malleolus and ankle joint.J Reconstr Microsurg. 2005; 21: 371-376
- Reconstruction of lower extremity after Grade III distal tibial injures using combined microsurgical free tissue transfer and bone transport by distraction osteosynthesis.Ann Plast Surg. 1993; 30: 98-104
- Free composite serratus anterior and rib flaps for tibial composite bone and soft-tissue defect.Plast Reconstr Surg. 1997; 99: 1656-1665
- Revisiting the serratus anterior rib flap for composite tibial defects.Plast Reconstr Surg. 2004; 114: 1871-1877
- A free transfer of both latissimus dorsi and serratus anterior flaps with thoracodorsal vessel anastomoses.Plast Reconstr Surg. 1982; 70: 620-629
- Long term results after muscle-rib flap transfer for reconstruction of composite limb defects.Microsurgery. 2011; 31: 218-222
Article info
Publication history
Published online: September 18, 2021
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2021 by the American College of Foot and Ankle Surgeons. All rights reserved.
