A Chimeric SCIP Flap With a Sartorius Muscle Component for Single-Stage Reconstruction of Late-Onset Navicular Osteomyelitis Following Degloving Injury: A Case Report.
Shigeki Ishibashi, Toko Umamoto, Maya Kanasaki et al.
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Case in brief
A 44-year-old man developed a painless cystic lesion on a free anterolateral thigh flap two years after a medial ankle degloving injury. Despite multiple debridements, imaging revealed a sinus tract to the navicular bone. Definitive debridement uncovered a retained anchor fragment and purulent tissue, leading to a significant soft-tissue defect. Reconstruction was achieved with a chimeric SCIP flap, resulting in successful healing and symptom resolution at one year.
What made this case unusual
The case illustrates the use of a chimeric SCIP flap with a sartorius muscle component for simultaneous dead-space obliteration and soft-tissue resurfacing in the context of late-onset osteomyelitis.
Diagnostic / clinical pearl
Clinicians should consider thorough imaging for recurrent wound issues following degloving injuries, as osteomyelitis may not be immediately apparent.
Why it matters
This case underscores the potential of innovative flap techniques in managing complex soft-tissue defects and osteomyelitis, enhancing surgical options for challenging reconstructions.