Abstract
Background As understanding of the blood supply by superficial circumflex iliac artery (SCIA)
to the skin and iliac bone has improved and the use of a perforator flap has become
accepted, most previous drawbacks of SICA iliac osteocutaneous flaps, such as bulky
flap, small diameter, and inadequate blood supply to bone, can now be overcome. Here,
the authors present their experience of using such flaps for the reconstruction of
complex defects in the foot and ankle with a focus on feasibility and safety.
Methods A retrospective review of patients who underwent foot and ankle reconstruction using
an SCIA iliac osteocutaneous flap between 2010 and 2015 was performed to assess outcomes.
Results Four patients who underwent treatment with SCIA iliac osteocutaneous flaps and eight
patients treated with fabricated chimeric iliac osteocutaneous flaps were identified.
The iliac segment size ranged from 1 × 3 × 0.7 to 3 × 6 × 1 cm and the skin paddle
size ranged from 1 × 4 to 8 × 16 cm. All flaps survived uneventfully except for marginal
necrosis in one anterolateral thigh (ALT) flap and one iliac osteocutaneous flap.
The median time to bone union was 4 months. All patients were able to walk in normal
footwear and none developed significant complications at the donor site.
Conclusion The use of free SCIA iliac osteocutaneous and fabricated chimeric iliac osteocutaneous
flaps provides an alternative for treating small- and medium-sized bone defects (smaller
than 8 cm) along with soft tissue defects in the foot and ankle region.
Keywords
iliac osteocutaneous flap - superficial circumflex iliac artery - fabricated chimeric
flap - foot and ankle - complex bone defect
