Subscribe to RSS
Reconstruction of the Lower Limb with Fasciocutaneous Flap of the Distal Pedicle - Modified Technique of Monteiro, Series of 15 Cases[*]Article in several languages: português | English
Objective To describe and demonstrate the outcomes of the modified Monteiro (1991) technique for lower limb reconstruction with a fasciocutaneous flap of the distal pedicle in a series of 15 cases.
Method We present the technique and outcomes from a series of 15 cases of the modified technique using a fasciocutaneous flap of the distal pedicle to repair the lower third of the leg and the foot.
Results Outcomes were satisfactory since these flaps provided good cutaneous and subcutaneous tissue coverage in cases with bone exposure and skin loss. The donor area was closed 3 days after surgery with a partial skin graft to provide better graft viability.
Conclusion The fasciocutaneous flap of the distal pedicle proved to be a good option for reconstruction of the middle and lower thirds of the leg, offering good bone coverage.
* Study performed at Hospital Universitário Lauro Wanderley (HULW-PB), Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil.
Received: 15 August 2019
Accepted: 02 March 2020
29 May 2020 (online)
© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
- 1 Ríos-Luna A, Villanueva-Martínez M, Fahandezh-Saddi H, Villanueva-Lopez F, del Cerro-Gutiérrez M. Versatility of the sural fasciocutaneous flap in coverage defects of the lower limb. Injury 2007; 38 (07) 824-831
- 2 Baumeister SP, Spierer R, Erdmann D, Sweis R, Levin LS, Germann GK. A realistic complication analysis of 70 sural artery flaps in a multimorbid patient group. Plast Reconstr Surg 2003; 112 (01) 129-140 , discussion 141–142
- 3 Rezende RBM, Macedo JLS, Rosa SC, Galli FS. Epidemiological profile and treatment of substance losses by trauma to the lower limbs. Rev Col Bras Cir 2017; 44 (05) 444-451
- 4 Ger R. The management of open fracture of the tibia with skin loss. J Trauma 1970; 10 (02) 112-121
- 5 Pontén B. The fasciocutaneous flap: its use in soft tissue defects of the lower leg. Br J Plast Surg 1981; 34 (02) 215-220
- 6 Ferreira MC, Besteiro JM, Monteiro Júnior AA, Zumiotti A. Reconstruction of the foot with microvascular free flaps. Microsurgery 1994; 15 (01) 33-36
- 7 Barclay TL, Cardoso E, Sharpe DT, Crockett DJ. Repair of lower leg injuries with fascio-cutaneous flaps. Br J Plast Surg 1982; 35 (02) 127-132
- 8 Donski PK, Fogdestam I. Distally based fasciocutaneous flap from the sural region. A preliminary report. Scand J Plast Reconstr Surg 1983; 17 (03) 191-196
- 9 Monteiro Júnior AA, Alonso N. Repair of cutaneous losses on the leg and foot with the distally based fasciocutaneous flap. Rev Soc Bras Cir Plast 1991; 6 (1/2): 33-40
- 10 Hallock GG. Utility of both muscle and fascia flaps in severe lower extremity trauma. J Trauma 2000; 48 (05) 913-917
- 11 Coehn M. Mastery of Plastic and Reconstructive Surgery. Boston: Little & Brown Co; 1994
- 12 Taylor GI, Corlett RJ, Dhar SC, Ashton MW. The anatomical (angiosome) and clinical territories of cutaneous perforating arteries: development of the concept and designing safe flaps. Plast Reconstr Surg 2011; 127 (04) 1447-1459
- 13 Benito-Ruiz J, Yoon T, Guisantes-Pintos E, Monner J, Serra-Renom JM. Reconstruction of soft-tissue defects of the heel with local fasciocutaneous flaps. Ann Plast Surg 2004; 52 (04) 380-384
- 14 Terzić Z, Djordjević B. Clinical aspects of reconstruction of the lower third of the leg with fasciocutaneous flap based on peroneal artery perforators. Vojnosanit Pregl 2014; 71 (01) 39-45
- 15 Costa-Ferreira A, Reis J, Amarante J. Reconstruction of soft-tissue defects of the heel with local fasciocutaneous flaps. Ann Plast Surg 2005; 54 (05) 580-581
- 16 Odom GL, Finney W, Woodhall B. Cervical disk lesions. J Am Med Assoc 1958; 166 (01) 23-28
- 17 Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 1976; 58 (04) 453-458
- 18 Amarante J, Costa H, Reis J, Soares R. A new distally based fasciocutaneous flap of the leg. Br J Plast Surg 1986; 39 (03) 338-340