Kronik kalkaneal osteomiyelit sonrası medial plantar arter flebi ve yapısal iliak kemik greftleri ile fonksiyonel topuk rekonstrüksiyonu: Bir olgu sunumu

Öz

Kronik kalkaneal osteomiyelite bağlı topuk defektlerinin rekonstrüksiyonu, sınırlı yumuşak doku bulunabilirliği, zayıf vaskülarite ve ağırlık taşımanın getirdiği işlevsel gereksinimler nedeniyle özellikle zordur. Birden fazla ameliyat sonrası kronik topuk defekti bulunan 41 yaşında bir erkek hastada çift katmanlı kemik grefti ve medial plantar arter (MPA) flebi kullanılarak yapılan tek aşamalı bir rekonstrüksiyonu bildiriyoruz. Kapsamlı debridmandan sonra, kalkaneal bütünlüğü sağlamak için süngerimsi ve kortikal kemik greftleri kullanıldı ve üstteki defekt bir MPA flebi ile kapatıldı. Ameliyat sonrası süreç, mükemmel flep perfüzyonu ve greft entegrasyonu ile sorunsuz geçti. Altıncı ayda hasta, koruyucu duyusunu koruyarak ağrısız yürümeye başladı. Bu teknik, dayanıklı, duyusal yumuşak doku kaplaması ve yapısal stabilite sağlayarak, kemik greftinin bir MPA flebi ile birleştirilmesinin, karmaşık topuk defektlerinin tek aşamalı rekonstrüksiyonu için güvenilir ve işlevsel bir seçenek olduğunu gösterdi.

Anahtar Kelimeler

• Fonksiyonel rekonstrüksiyon
• İliak kemik grefti
• Kalkaneal osteomiyelit
• Medial plantar arter flebi
• Topuk rekonstrüksiyonu

Functional heel reconstruction after chronic calcaneal osteomyelitis using a medial plantar artery flap and structural iliac bone grafts: A case report

Öz

Reconstruction of heel defects secondary to chronic calcaneal osteomyelitis is particularly challenging due to limited soft-tissue availability, poor vascularity, and the functional demands of weight-bearing. We report a single-stage reconstruction using a dual-layer bone graft and medial plantar artery (MPA) flap in a 41-year-old male with a chronic heel defect following multiple surgeries. After thorough debridement, cancellous and cortical bone grafts were used to restore calcaneal integrity, and the overlying defect was covered with an MPA flap. The postoperative course was uneventful, with excellent flap perfusion and graft integration. At six months, the patient achieved pain-free ambulation with preserved protective sensation. This technique provided durable, sensate soft-tissue coverage and structural stability, demonstrating that combining a bone graft with an MPA flap is a reliable, functional option for single-stage reconstruction of complex heel defects.

Anahtar Kelimeler

• Calcaneal osteomyelitis
• Functional reconstruction
• Heel reconstruction
• Iliac bone graft
• Medial plantar artery flap

Kaynakça

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