Treatment of Chronic Lower Extremity Wound Complicated by Osteomyelitis: Using Partial Biceps Femoris Muscle Flap

Abstract

In many cases chronic wounds in the lower extremities are extremely difficult to heal because of inadequate blood supply, and when wounds are complicated by osteomyelitis, plastic surgeons and orthopedic surgeons must join forces to facilitate treatment. A 63-year-old man with bone exposure and a peripherally indurated chronic open wound complicated by osteomyelitis of the right distal thigh was admitted to the department of orthopedic surgery at our hospital. He was referred to our department for treatment of the right side chronic open wound. We report our successful experience with a partial biceps femoris muscle transposition flap with fasciocutaneous expanded-keystone advancement flap following wound and bone debridement for the coverage of complex wounds associated with bone infection. The results show two discrete layers of muscle. In patients with chronic osteomyelitis, fasciocutaneous flaps might provide a more effective means of covering full-depth soft tissue defects without donor site morbidity, compared to free flaps.