The Adipo-Fascial ALT Flap in Lower Extremities Reconstruction Gustillo IIIC-B Fractures. An Osteogenic Inducer?

Abstract

Background: Purpose of this report is to analyze possible effects and clinical outcomes of anterolateral thigh (ALT)-free fascial flaps on bone healing in Gustilo type IIIB-C open tibial fractures.

Methods: We present a technique, wherein the fascia is wrapped around bone stumps, bone chips or not vascularized bone graft were used to fill the defects. Five patients with a mean follow-up of 36 months were treated.

Results

Mean time from injury to flap coverage was 72 hours. The mean size of bone defects was 4-7,6 cm. All flaps were Antero Lateral Tight flaps, and the fracture sites did not have any evidence of infection. None of the patients was a smoker. A solid bone union was reached, and full wearing was in a mean of 11 (4–20) weeks after the injury. The lower limb was saved in 100% of the cases.

Conclusion

Despite the goods results, further studies applied on a large number of patients are needed to confirm authors theory, however, we can consider the fascial ALT flap as a valid help for bone healing in 3B-C open tibial fractures.

Keywords:

• microsurgery
• lower extremities reconstruction
• fascial flap
• ALT flap
• osteogenic induction

Acknowledgments

None

Conflict of interest statement

The authors have no conflicts of interest to declare.

Ethical statement

no funds were received for the production of the manuscript. Authors declare that they have no conflict of interest. All procedures performed were in accordance and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.