Điều trị khuyết hổng mô mềm 1/3 dưới cẳng chân, cổ và bàn chân bằng vạt da-cân trên mắt cá ngoài cải tiến

Abstract

Background: Soft-tissue defects of the distal third of the leg, ankle, and foot often present with exposed tendon and bone, are prone to infection, and cause functional impairment; therefore, durable coverage is required. The lateral supramalleolar fasciocutaneous flap is an appropriate option, and technical modifications-extending the proximal limit of the flap and elevating a fasciocutaneous flap on a adipofascial pedicle, help expand the flap reach and coverage. Objective: Evaluate outcomes of treating distal third leg-ankle-foot soft tissue defects using the modified lateral supramalleolar fasciocutaneous flap. Subject and method: A descriptive case series of 28 patients with distal third leg-ankle-foot soft tissue defects operated on at Can Tho Central General Hospital (June 2024-December 2025), followed for up to 3 months. Outcomes included flap viability, functional results using the Hashmi score, and scar assessment using the VSS. Results: Mean age was 49 years; the main etiologies were infection and trauma, most commonly involving the heel and dorsum of the foot. Early results showed 75% complete flap survival; by 3 months, 100% achieved complete wound healing. Hashmi outcomes were excellent in 57.1% and good in 42.9%; VSS scores were low with acceptable aesthetics. Conclusion: The lateral supramalleolar flap with the described modifications is a safe and effective method for coverage of distal third leg-ankle-foot defects.