Lateral Supramalleolar Flap for Treatment of Intractable Infected Bursitis of Lateral Malleoulus.

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We successfully treated intractable infected lateral malleolar bursitis with radical dèbridement and lateral supramalleolar flap in 4 patients. The lateral supramalleolar flap, described by Masquelet, is a fasciocutaneus flap supplied by the perforating branch of the peroneal artery. All 4 patients were male whose age at surgery ranged from 49 to 58 (mean 54 year-old). All patients showed some complications, such as hypesthesia in both legs with cervical myelopathy, akinesia with schizophrenia, anesthesia in both legs with meningocele and alcoholic polyneuritis. The preoperative period of the conservative treatment ranged from 6 weeks to 3 years 9 months (mean 2 years and 5 months). Skin defect after radical debridement of the bursitis including resection of the bony spur was covered with lateral supramalleolar flap (length 4-7cm, width 4-5cm). Skin graft was performed to cover the donor site. The length of follow-up ranged from 3 months to 5 years (mean 2 years and 5 months). All flaps survived completely and there has been no recurrence of the bursitis. We consider lateral supramalleolar flap the treatment of choice for the coverage of the lateral malleolus. The advantages of this flap included relatively large size, and stable blood flow by orthograde flow.
西日本整形・災害外科学会の論文