The Gradual Expansion Muscle Flap
Abstract
High energy open fractures of the tibia have traditionally been fraught with challenges to include bone comminution or loss, soft tissue loss, nonunion, and infection. A number of techniques have been implemented to treat the severe soft tissue loss typically involving the anteromedial surface of the tibia to include wet to dry dressings or Papineau techniques, negative pressure wound therapy, acellular dermal matrices, and rotational or free tissue transfer with Masquelet technique, primary shortening, and distraction osteogenesis to address bone loss. We present a novel technique and subsequent case series that obviates the need of free tissue transfer while treating high energy type IIIB open tibia fractures by performing an acute shortening and angulation of the tibia and rotational muscle flap coverage and split thickness skin grafting of the soft tissue defect. Distraction histiogenesis with circular external fixation is then used to correct the residual osseous deformity while stretching the rotational muscle flap.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2014
- Accession Number
- ADA614477
Entities
People
- Christopher R. Rathbone
- James A. Blair
- Joseph R. Hsu
- Michael J. Beltran
Organizations
- San Antonio Military Medical Center