[Clinical application of tibial bone-skin flaps in treatement of infective bone-skin defects of leg].

OBJECTIVES: To investigate the clinical therapeutic effect of tibial bone-skin flaps in the repair of infective bone-skin defects of the leg. METHODS: Between February 2000 and March 2005, 68 cases of leg infective wounds with tibial bone and skin defects were treated: 4 cases using free grafting, 64 cases using cross-leg or ipsilateral transposition grafting of tibial bone-skin flaps so that the tibial support continuity of the affected leg could be reconstructed and the wound could be covered at one stage. The skin flap area ranged from 9 cm x 4 cm to 25 cm x 12 cm and the bone flap length ranged from 6 cm to 21 cm. RESULTS: The flaps were completely survived in 67 of the 68 cases except 1 case which was repaired by fibular bone-skin flaps because of the failed blood-vessel anastomosis; the bone flaps were healed in 66 cases, except 1 case which had delayed union of the proximal end through 6-month follow-up because tibial bone flap was lengthened, leading to long soft tissue stripping of the proximal end. All the 68 patients were followed up 6 months to 5 years. The leg function and contour were satisfactory 2 years after operation. Those patients followed up more than 2 years showed normal weight loading walking without obviously abnormal gait, and can engaged in original work. CONCLUSION: On the basis of sufficient anti-infection, the one-stage reconstruction of tibial support continuity and the covering of wound by the three methods are suitable for many types of leg bone and skin defects, have a great application value and high successful rate and can retain the affected limb and create the conditions for the functional recovery.