[Free iliac flap grafting for repair of tibia traumatic osteomyelitis complicated with bone-skin defect].

OBJECTIVE

To investigate the method and clinical effect of free iliac flap grafting in repairing the tibia traumatic osteomyelitis complicated with bone-skin defect.

METHODS

From June 2001 to February 2006, 28 patients with tibia traumatic osteomyelitis complicated with bone-skin defect were treated with free iliac flap grafting at stage I. There were 18 males and 10 females, with an average of 32.5 years(18-68 years). There were traffic injury in 11 cases, bruise in 6 cases, explosive injury in 5 cases, machinery injury in 4 cases, and falling injury in 2 cases. The disease courses of patients were 1-6 months. All patients had been treated by 2-6 operations. The wounds located at the mid and upper tibia in 13 cases, and the inferior tibia in 15 cases. The length of free iliac was 0.5-6.0 cm and the size of the flap ranged from 4.5 cm x 3.5 cm to 28.0 cm x 16.0 cm. The external fixation were applied in 18 cases, and steel plate were applied in 10 cases. The donor sites were sutured directly.

RESULTS

All of the flaps survived completely. The wounds healed by first intention in 26 cases and by second intention in 2 cases. The donor sites healed by first intention. Twenty-eight patients were followed up for 6 to 56 months (mean, 30 months). The appearances of the flaps were satisfactory and the colour was similar to recipient site. All grafted bone united 2-14 months (mean, 4.6 months) after operation according to X-ray examination. In 20 patients who did not achieved union before operation, fracture healed 2 to 6 months after operation(mean, 3.2 months). Osteomyelitis recurred 12 months after operation in 2 cases and healed by nidus clearing.

CONCLUSION

Free iliac flap which used to repair tibia traumatic osteomyelitis complicated with bone-skin defect, can repair the defect at stage I and enhance the anti-infectious ability. It is one of appropriate and effective clinical methods.