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

Hyung Suk Yi; Hyo Seong Kim; Sung Tack Kwon; Eui Cheol Jeong

doi:10.12790/jkssh.2014.19.4.189

Journal List > J Korean Soc Surg Hand > v.19(4) > 1106469

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Yi, Kim, Kwon, and Jeong: Treatment of Chronic Osteomyelitis in the Hand with Anterolateral Thigh Free Flap and Autologous Iliac Bone Graft

CASE REPORT

J Korean Soc Surg Hand 2014;19(4):189-194.

Published online: 11 December 2014

DOI: https://doi.org/10.12790/jkssh.2014.19.4.189

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

Hyung Suk Yi^1,², Hyo Seong Kim^1,², Sung Tack Kwon^1,², Eui Cheol Jeong^2,³

¹Department of Plastic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

²Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea

³Department of Plastic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea

Correspondence to: Eui Cheol Jeong, Department of Plastic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 156-707, Korea, TEL: +82-2-870-2331, FAX: +82-2-831-2826, E-mail: ejeong.md@gmail.com

^* This paper was introduced at 2013 Annual Meeting of The Korean Society for Surgery of the Hand.

Received 3 September 201429 October 2014 Accepted 13 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Finger phalanges, Chronic osteomyelitis, Free tissue flap, Bone transplantation

REFERENCES

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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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