J Korean Soc Surg Hand.  2014 Dec;19(4):189-194. 10.12790/jkssh.2014.19.4.189.

Treatment of Chronic Osteomyelitis in the Hand with Anterolateral Thigh Free Flap and Autologous Iliac Bone Graft

• Yi HS
• Kim HS
• Kwon ST
• Jeong EC

• KMID: 1896908
• DOI: http://doi.org/10.12790/jkssh.2014.19.4.189

Abstract

Adequate debridement and flap operations are effective treatment methods for chronic osteomyelitis. Several flap operations have been described for treating chronic osteomyelitis in various regions. We performed anterolateral thigh fasciocutaneous free flap and iliac bone graft for treating posttraumatic chronic osteomyelitis in hand. The result was successful with satisfactory control of osteomyelitis and avoiding amputation of fingers.

Keyword

Finger phalanges; Chronic osteomyelitis; Free tissue flap; Bone transplantation

MeSH Terms

Amputation
Bone Transplantation
Debridement
Finger Phalanges
Fingers
Free Tissue Flaps*
Hand*
Osteomyelitis*
Thigh*
Transplants*

Figure

• 

  Fig. 1. Preoperative view. (A) The chronic open wounds on right hand manifested with mutiple surgical scars and exposed bone. All fingers except the thumb were already in the stiff extension posture. (B) The X-ray finding showed amputated status of small finger and osteolytic condition in index and ring finger.

• 

  Fig. 2. (A) The debridments of the infected bone and soft tissue was done. And amputation of ring finger was done. (B) The soft tissue was covered by anterolateral thigh free flap. (C) Immediate postoperative X-ray, Antibiotic contained bone cement beads were filled for spacer.

• 

  Fig. 3. (A) Debulking procedure of the flap and subsequent iliac bone graft. (B) Immediate postoperative X-ray. (C) Postoperative view after 7 months. No recurrence of chronic osteomyelitis (D) Postoperative X-ray after removal of the K-wires.

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