[Clinical application of tibial composite saphenous nervetissue flap for the treatment of traumatic bone-skin defect of leg].

OBJECTIVE: To investigate the effect of tibial composite saphenous nerve tissue flap in repairing traumatic bone-skin defect of leg.

METHODS: From February 2009 to May 2015, 23 patients with focile skin defect caused by trauma were treated, including 18 males and 5 females, aged from 8 to 59 years old with an average age of 35.6 years old. Length of tibia bone cortex defect ranged from 4 to 12 cm, width ranged from 2 to 2.5cm, skin defect ranged from 8 cm× 3 cm to 18 cm× 11 cm, all the wound surfaces had purulent exudation. Cross shift and ipsilateral shift methods of tibial composite saphenous nerve tissue flap were used to reconstruct continuity of the injured limb tibial brace and repair wound surface. Cutting flap ranged from 9 cm× 4 cm to 20 cm × 12 cm, bone flap length was 6 to 15 cm, width was 1.5 to 2.5 cm. Fracture healing time and recovery of limb function were observed.

RESULTS: At 3 to 5 months after operation, bone flap and area of affected area were healed with an average of 4.7 months. Twenty-three cases were followed up for 6 months to 5 years with an average of 30.3 months. Thirteen patients were able to walk without abnormal gait and could be engaged into original work. According to Enneking evaluation systems, 13 patients obtained excellent results, 8 moderate and 2 poor.

CONCLUSIONS: With tibial composite saphenous nerve tissue flap transplantation at stage one to repair tibia and skin defects according to specific condition of affected limbs has a high rate of success and creates less damage to region of limb injury, which is an ideal method to repair skin defect of focile.