MICROVASCULAR RECONSTRUCTION OF THE FOOT - WEIGHT-BEARING PATTERNS, GAIT ANALYSIS, AND LONG-TERM FOLLOW-UP

被引:65
作者
GOLDBERG, JA [1 ]
ADKINS, P [1 ]
TSAI, TM [1 ]
机构
[1] CHRISTINE M KLEINERT INST HAND & MICRO SURG,1 MED CTR PLAZA,SUITE 850,225 ABRAHAM FLEXNER WAY,LOUISVILLE,KY 40202
关键词
D O I
10.1097/00006534-199392050-00017
中图分类号
R61 [外科手术学];
学科分类号
摘要
Between 1980 and 1989, 46 free-tissue transfers (32 skin flaps, 14 muscle flaps) were performed in 44 patients for foot reconstruction. Patient age averaged 25.8 years (range 2 to 74 years). Length of follow-up averaged 43 months. Flap survival rate was 96 percent. Debulking was done in 16 skin and 8 muscle flaps. The ulceration rate in 25 patients with weight-bearing flaps was 32 versus 11 percent in 19 patients with non-weight-bearing flaps. Time before ambulation averaged 6.4 months following weight-bearing reconstruction and 4.5 months following non-weight-bearing reconstruction. All patients with either abnormal foot-mat diagrams or major gait abnormalities had significant underlying radiologic foot abnormalities or nerve injuries. We conclude that both skin and muscle free flaps frequently need secondary debulking procedures to improve function. The ulceration rate tends to be higher in weight-bearing flaps than in non-weight-bearing flaps. Underlying bony architecture and nerve function affected weight-bearing patterns and gait more than type of wound coverage.
引用
收藏
页码:904 / 911
页数:8
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