Reconstruction of the ankle complex wound with a fabricated superficial circumflex iliac artery chimeric flap including the sartorius muscle: A case report

• Published in: Microsurgery 2017-07, Vol.37 (5), p.421-425
• Main Authors: Yoshimatsu, Hidehiko, Yamamoto, Takumi, Hayashi, Nobuko, Kato, Motoi, Iida, Takuya, Koshima, Isao
• Format: Article
• Language: English
• Subjects: Aged; Ankle Injuries - surgery; Female; Humans; Iliac Artery - surgery; Muscle, Skeletal - surgery; Reconstructive Surgical Procedures - methods; Surgical Flaps - blood supply; Surgical Flaps - surgery
• ISSN: 0738-1085; 1098-2752
• DOI: 10.1002/micr.22518

Free flap reconstruction of the foot and ankle can be challenging in that it must fulfill functional and esthetic demands. Injury of this region is often associated with fractures, and muscle flaps are sometimes preferred. Here we present a case of the use of superficial circumflex iliac artery (SCIA) chimeric flap for reconstruction of ankle complex wound. A 78‐year‐old lady sustained open fractures of the left distal tibia, fibula, and talus, with a 10 × 6 cm2 soft‐tissue defect over the lateral aspect of her left ankle due to an automobile accident. A 7 × 3 cm2 sartorius muscle component was inset to cover the exposed left ankle joint capsule, and a 5 × 10 cm2 SCIP skin paddle was used for coverage of the defect. The postoperative course was uneventful, and the sartorius muscle component and the SCIP skin paddle survived completely. Six months after the reconstruction, the flap and the donor site showed pleasing cosmesis, and the patient could ambulate with a supple ankle without crutches. The sartorius muscle component was elevated based on the deep branch of the SCIA, and was chimerically combined with a SCIP skin paddle for reconstruction of a complex ankle injury. © 2015 Wiley Periodicals, Inc. Microsurgery 37:421–425, 2017.