Clinical Research
Reconstruction of lateral malleolus with a free iliac bone graft
Quanhong Du, Yongan Shi, Haibo Cong, Haiming Sui, Jianguo Zhai, Qingmin Yang, Taosheng Chi, Bingjun Ma
Published 2016-06-15
Cite as Chin J Orthop Trauma, 2016, 18(6): 493-497. DOI: 10.3760/cma.j.issn.1671-7600.2016.06.007
Abstract
ObjectiveTo explore reconstruction of lateral malleolus with a free iliac bone graft.
MethodsThe clinical data of 5 patients with traumatic compound loss of lateral malleolus and skin were retrospectively analyzed who had been treated at our department from June 2010 to April 2012. They were 3 males and 2 females, 23 to 56 years of age (average, 35.4 years). The bone defect was on the left side in 2 cases, on the right side in 3 cases, and beyond the inferior syndesmosis in all. The bone defects ranged from 3.2 cm to 4.5 cm in length. In the staged treatment, the wounds were repaired by free skin flap transplantation in the first stage while the lateral malleolus defects were rebuilt with a free iliac bone graft in the second stage.
ResultsThe skin flaps survived primarily in all the 5 cases. All the cases were followed up for 33 to 38 months (average, 35.4 months). The bone healing time was from 5.5 to 8.0 months (average, 6.8 months). Arthritis occurred 11 months after surgery and limping gait was found 35 months after surgery in one case whose lateral articular surface of the talus was found partially stripped intraoperatively. No limping gait or pain was found in the other 4 cases who obtained a stable ankle with nearly a full range of motion. Their joint surface was matching, and their joint clearance was normal. No secondary fractures occurred. According to the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale, they scored more than 90 points at the final follow-ups.
ConclusionReconstruction of lateral malleolus with a free iliac bone graft can lead to positive therapeutic effects and ideal long-term outcomes.
Key words:
Ankle; Wounds and injuries; Ilium; Reconstructive surgical procedures; Transplantation
Contributor Information
Quanhong Du
Department of Hand Bone Microsurgery, Wendeng Orthopaedics Hospital, Wendeng 264400, Shandong, China
Yongan Shi
Department of Hand Bone Microsurgery, Wendeng Orthopaedics Hospital, Wendeng 264400, Shandong, China
Haibo Cong
Wendeng Cen, tral Hospital of Weihai, Weihai 264400, Shandong, China
Haiming Sui
Department of Hand Bone Microsurgery, Wendeng Orthopaedics Hospital, Wendeng 264400, Shandong, China
Jianguo Zhai
Department of Hand Bone Microsurgery, Wendeng Orthopaedics Hospital, Wendeng 264400, Shandong, China
Qingmin Yang
Department of Hand Bone Microsurgery, Wendeng Orthopaedics Hospital, Wendeng 264400, Shandong, China
Taosheng Chi
Department of Hand Bone Microsurgery, Wendeng Orthopaedics Hospital, Wendeng 264400, Shandong, China
Bingjun Ma
Department of Hand Bone Microsurgery, Wendeng Orthopaedics Hospital, Wendeng 264400, Shandong, China