Superficial circumflex iliac artery based fascial pedicle bi-lobed iliac bone flap transfer for reconstruction of foot composite tissue defects

Abstract Background: To investigate the clinical efficacy of repairing the large-sized compound tissue defects in the foot with the free superficial circumflex iliac artery (SCIA) based fascial pedicle bi-lobed iliac bone flap. Methods: A retrospective analysis from October 2009 to February 2017 was performed, and 11 patients were identified with large-sized compound tissue defects repaired with the free SCIA based fascial pedicle bi-lobed iliac bone flap. The size of wound ranged from 12 cm × 10 cm to 15 cm × 13 cm and the length of the bony defect was from 4 cm to 7 cm. The flap sizes ranged from 13 cm × 10 cm to 16 cm × 14 cm, and the length of the dissected iliac ranged from 5 cm to 8 cm. The donor sites were primarily closed. Results: All 11 flaps survived engraftment including one case venous crisis occurred. After 6 months, only one of the cases resulted in swollen flaps which required repair. All other engrafted flaps were well appearing and the transplanted iliac healed smoothly, with a bone healing time of less than 12 weeks. The internal fixation was removed between 12 and 24 weeks post operation. Successful postoperative recovery of ankle joint flexion and extension resulted in normal gait. Conclusions: The free SCIA-based fascial pedicle bi-lobed iliac bone flap repaired the large-sized compound tissue defect in the foot, resulting in repaired bone defect, wound coverage, low donor site morbidity, and recovery of function.