ABSTRACT
Soft-tissue reconstruction alone cannot obtain normal ankle function in patients with
large defects in the area of the lateral malleolus. The authors report a functional
reconstructive method for the lateral malleolus, utilized in a male patient whose
osteosarcoma in the fibula was resected with surrounding soft tissue. In order to
reconstruct the lateral malleolus, the remaining half of the fibula at the knee was
removed, and the fibular head was fixed with the tibia at the ankle joint. Ligaments
were reconstructed with tendon grafts. Skin and soft-tissue defects were reconstructed
with a combined composite flap comprised of a latissimus dorsi myocutaneous flap and
a serratus anterior muscle flap. Dead space around the bone graft was filled with
the serratus anterior muscle flap that was divided into two portions. The surface
was covered with the latissimus dorsi myocutaneous flap. The patient regained almost
normal function of the ankle joint. This technique would be a useful functional reconstructive
method for patients with large defects in the area of the lateral malleolus.
KEYWORDS
Functional reconstruction of ankle joint - combined composite flap - divided serratus
anterior muscle flap
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Kensuke KiyokawaM.D. Ph.D.
Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume
University School of Medicine
67, Asahi-machi, Kurume
Fukuoka 830-0011, Japan
