Free Composite Serratus Anterior-Latissimus-Rib Flaps for Acute One-Stage Reconstruction of Gustilo IIIB Tibia Fractures

Matthew T. Houdek, Eric R. Wagner, Chad D. Watts, Stephen A. Sems, Steven Lawrence Moran

Research output: Contribution to journalArticle

Abstract

Gustilo IIIB injuries of the tibia with segmental bone loss continue to be a difficult reconstructive problem. The serratus anterior-latissimus-rib (SALR) composite flap consists of bone and muscle; this flap can provide soft tissue coverage and vascularized bone in a single surgical procedure. The purpose of this study is to describe the use of the SALR flap for the treatment of a large open tibia fracture with segmental bone loss, with a specific focus on postoperative complications, limb salvage, and time to union. We reviewed the medical records of patients undergoing an SALR flap (n = 5) for the treatment of Gustilo Type IIIB tibia fractures within 1 month of injury. We compared the mechanism of injury, injury severity score, time from injury to free tissue transfer, complications, and time to radiographic and clinical union. All patients were male, with a mean age of 25 years. On average, patients underwent free tissue transfer within 1 week of injury. The average time to radiographic union was 7 months. Two patients underwent reoperation. There were no graft failures. Free SALR flaps can be a useful option for the treatment of high-energy tibia fractures with extensive soft tissue and bone loss. These flaps provide immediate osseous and soft tissue reconstruction with an acceptable complication profile.

Original languageEnglish (US)
JournalAmerican journal of orthopedics (Belle Mead, N.J.)
Volume47
Issue number6
DOIs
StatePublished - Jun 1 2018

Fingerprint

Ribs
Tibia
Bone and Bones
Wounds and Injuries
Limb Salvage
Open Fractures
Injury Severity Score
Reoperation
Medical Records
Therapeutics
Transplants
Muscles

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Free Composite Serratus Anterior-Latissimus-Rib Flaps for Acute One-Stage Reconstruction of Gustilo IIIB Tibia Fractures. / Houdek, Matthew T.; Wagner, Eric R.; Watts, Chad D.; Sems, Stephen A.; Moran, Steven Lawrence.

In: American journal of orthopedics (Belle Mead, N.J.), Vol. 47, No. 6, 01.06.2018.

Research output: Contribution to journalArticle

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