This article introduced a newmethod of repaire of osteocutaneousdefect of the lower leg by thetransfer of periosteocutaneous flap.The donor artery was the posteriortibial artery which supplied the skinof the medial aspect of the middleand lower leg. The medial skin flapof the leg had vascular communicat-ion with the periostium of the ant-erior aspect of the tibia. The shapeand size of the flap could be design-ed according to the recipient area,and the flap axis should be along theline from medial tibial condyle to the medial malleolus, generelly at the level of 3.7.11. or 15cm above the medial malleolus. The skin defect could be repaired by free graft, and 2 patients received this operation had achieved good result after 1 year follow-up.
OBJECTIVE In order to increase the survival area of pedicled fasciocutaneous flap, a multiple pedicled blocking randomized fasciocutaneous flap was designed. METHODS From January 1991 to September 1998, this technique was used to repair 33 cases, including 27 males and 6 females and the ages ranged from 6 to 58 years. All of the patients were suffered from traffic accidents. In these cases, 22 cases had skin defects of legs and feet with bone, nerve and tendon exposed, 5 cases had osteomyelitis as well as internal fixaters exposed and the other 6 had deformity from scar. The size of the flap was 25.0 cm x 13.0 cm x 2.4 cm at its maximum and 6.0 cm x 3.5 cm x 1.5 cm at its minimum. Based on the traditional blocking flap, according to the severity of the wound and conditions of the neighboring tissues, a flap having 2 to 4 orthogonal pedicles with a width of 1.5 to 3.0 cm was designed. The medical-graded stainless steel sheet was implanted below the deep fascia, and after blocking for 3 to 6 days, the side pedicles were divided. 6 to 14 days later, one of the two remaining pedicles was divided and was transferred to repair the defect. RESULTS 31 cases were followed up for 6 months to 5 years without any trouble of the joints. The flap had a good external appearance and was high pressure-resistant. CONCLUSION The multiple pedicled blocking randomized fasciocutaneous flap increased the size of the flap and the length to width ratio. It had the following advantages: manage at will, high resistance to infection and a large survival area of flap.