Application Of Latissimus Dorsi Flap Combined With Iliac Bone Flap In The Treatment Of Chronic Osteomyelitis Of The Leg

Objective: To explore the operative method and clinical effect of latissimus dorsi flap combined with iliac bone flap for the treatment of chronic osteomyelitis of the leg.Methods: A retrospective analysis from June 2009 to December 2016,the clinical data of latissimus dorsi muscle flap combined with iliac bone flap transplantation for repair of chronic osteomyelitis of lower leg in 10 patients,male 7 cases,female 3 cases;at the age of 12～52,with an average of 33.4 years;bone infections were caused by open injury,chronic osteomyelitis of the treatment cycle is 11 months to 3 years;4 cases of chronic osteomyelitis of tibia,6 cases of distal tibial chronic osteomyelitis;one-stage extended lesion removal,free latissimus dorsi flap filling die cavity,wound healing after 6～10 months of free iliac bone flap transplantation for repairing bone defect.Results:The latissimus dorsi flap survived,and 8 patients healed in one stage after operation,and 2 patients had delayed healing in 2 months.After the iliac bone flap,the wound healed in one stage,and all of the 8 cases of the flap carried by the iliac flap survived.All the patients 4～12 months after surgery to repair bone defect bone healing,removing internal fixation of external fixation and functional exercise,were followed up for 6 months to 8 years at the end of 1 after surgery,tibia healed,the skin quality,no recurrence of osteomyelitis,sinus.There were 2 cases of latissimus dorsi flap without contracture of skin graft,and the remaining linear scarring in the other back and iliac donor sites.Conclusions: The use of latissimus dorsi flap combined with iliac bone flap in the treatment of chronic osteomyelitis of the leg can effectively control infection,rebuild bone defect and restore lower limb function,and achieve satisfactory clinical results.