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Journal of the Korean Society of Traumatology 2008;21(2):140-143.
Early Resurfacing Using Gastrocnemius Muscle Flap Transposition for Degloving Injury with Exposure of Proximal Tibia
Hii Sun Jeong, Hye Kyung Lee
1Department of Plastic & Reconstructive Surgery, Kwandong University College of Medicine, Gyeonggi-do, Korea.
2Merit Plastic Surgery Clinic, Seoul, Korea. meritps@gmail.com
근위부 경골 노출을 동반한 벗겨진 손상의
장딴지 근육 피판을 이용한 조기 피복 치험례
관동대학교 의과대학 성형외과학교실, 메리트성형외과의원1
Degloving injuries result from the tangential force against the skin surface, with resultant separation of the skin and the subcutaneous tissue from the rigid underlying muscle and fascia. These injuries are associated with extensive soft tissue loss and occasionally with exposure of bone, and they require reconstructive modality for resurfacing and successful rehabilitation that considers the vascular anatomy and the timing of the operation. A 19-year-old male patient was transferred to our facility with degloving injury extending from the lower third of the right thigh to the malleolar area. The tibial bone was exposed to a size of 2x3.5 cm2 on the upper third of the lower leg at the posttraumatic third day. The exposed soft tissue was healthy, and the patient did not have any other associated disease. At the posttraumatic sixth day, one-stage resurfacing was performed with a medial gastrocnemius muscle flap transposition for the denuded bone and a split-thickness skin graft for the entire raw surface. The transposed gastrocnemius muscle attained its anatomical shape quickly, and the operating time was relatively short. No transfusion was needed. This early reconstruction prevented the accumulation of chronic granulation tissue, which leads to contracture of the wound and joint. The early correction of the gastrocnemius muscle flap transposition made early rehabilitation possible, and the patient recovered a nearly full range of motion at the injured knee joint. The leg contour was almost symmetric at one month postoperatively.
Key Words: Degloving injury; Gastrocnemius muscle flap
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