Use of fibula flaps to treat persistent talonavicular nonunion: A report of three cases

Utilization of the Pedicled and Free Fibula Flap for Ankle Arthrodesis

Ankle arthrodesis has become a common surgical procedure for individuals with end-stage ankle arthritis, chronic infection, and bony misalignment. Although arthrodesis is typically managed with arthrodesis in situ or realignment, reconstruction may be utilized for patients with more complicated cases that involve metatarsal defects. Our institution utilizes both the pedicled and free fibula flaps for surgical management pertaining to ankle arthrodesis. Our study looks to evaluate the work of a single plastic surgeon and identify patient postoperative outcomes.

The use of free fibula-flexor hallucis longus osteomuscular flap for calcaneal reconstruction after partial calcanectomy for the chronic osteomyelitis: A case report

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Calcaneal osteomyelitis is difficult to eradicate.

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Calcaneal debridement and infection control are critical.

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Osteomuscular flaps offer a stable and effective reconstruction.

Introduction

Calcaneal osteomyelitis poses a tough challenge for any reconstructive surgeon. The eradication of the infection and the reconstruction of the defect are the main goals of treatment.

Presentation of case

We present the case of a 53-year-old male with chronic calcaneal osteomyelitis. The patient was submitted to several bone and soft tissue debridements and twice the application of gentamicin/sulfate implants at the wound bed with no success. He was then submitted to a partial calcanectomy followed by obliteration of the bone defect (4.5 × 2 × 1.5 cm) with a free vascularized fibula-flexor hallucis longus osteomuscular flap (bone dimension:4.5 × 1.5 × 1.2 cm; muscle size: 4 × 1.5 × 0.5 cm). The flap remained viable, and the post-operative period was uneventful. Bone incorporation was evident nine months after the surgery with no signs of recurrent infection or avascular necrosis. Final follow up, at one year, showed an excellent functional result. The patient was able to ambulate without assistance and referred occasional minimal foot pain. Donor site morbidity was minimal.

Conclusion

The authors believe that this osteomuscular flap may be a valuable option to reconstruct calcaneal defects after chronic osteomyelitis.