A partially de-epithelized sural flap with a distal vascular pedicle in the treatment of distal tibial osteomyelitis

To cover a post-surgical bone defect is an essential part of successful treatment of osteomyelitis of long bones in addition to radical surgical treatment and osteonecrectomy. Autologic vascularized tissues is the best option to fill the infected bone defect. However, if a pathological focus is localized in the distal part of tibia, the deficit of surrounding soft tissues makes the replacement of infected tibial defect a difficult task. One of the ways to solve the discussed problem is application of de-epithelized part of fasciocutaneous sural flap with a distal feeding pedicle. The article describes specific features of this surgical technique and outcomes of treatment in three patients with post-traumatic osteomyelitis (type III by Czerny – Mader classification). Our experience allows us to recommend this technique for treating an infected cavity in the medullary canal of the distal part of tibia.