[Objective]To compare the clinical outcomes of three kinds of flaps in repairing soft tissue defect complicated with open ankle joint fracture and dislocation.[Methods]A retrospective study was conducted on 51 patients who received surgical treatment for soft tissue defect complicated with open ankle fracture and dislocation in our department from January 2015 to February 2021.According to doctor-patient communication,29 cases received perforating artery perforator flap(PAPF),15 cases received sural neurocutaneous flap(SNCF),and 7 cased underwent anterolateral thigh flaps(ALTF).The documents of perioperative period and follow-up were compared among the three groups.[Results]The ALTF group proved significantly greater than the PAPF and SNCF in terms of operation time of[(165.5±26.4)min vs(125.3±13.8)min vs(120.8±11.3)min,P＜0.001],flap area[(62.7±6.7)cm2 vs(55.3±6.4)cm2 vs(54.9±8.2)cm2,P=0.038],intraoperative blood loss[(298.6±30.7)ml vs(238.9±38.9)ml vs(229.6±30.7)ml,P＜0.001],whereas there were no statistical signifi-cances between PAPF and SNCF groups in abovesaid items(P＞0.05).However,there were no significant differences among the three groups in terms of the time interval of two stage operations,the closure form of donor area,the healing of donor area,and the hospital stay(P＞0.05).All the patients in the 3 groups were followed up for a mean of(14.7±2.0)months,and there was no significant difference in the time to resume full weight-bearing activity among the three groups(P＞0.05).The VAS score,ankle dorsal-plantar flexion ROM,AOFAS score and donor scar score were significantly improved over time(P＜0.05).The PAPF group got significant improvement in sensory function with time(P＜0.05),while the SNCF group and ALTF group had it remained unchanged(P＞0.05).At the last follow-up,the ankle dorsal-plantar flexion ROM in PAPF and SNCF groups was significantly better than that in ALTF group[(62.1±5.1)° vs(61.7±6.2)° vs(54.9±5.3)°,P=0.010].The PAPF and ALTF group were significantly better than SNCF in terms of sensory function[excellent/good/fair/poor:(17/7/3/2)vs(4/1/1/1)vs(2/3/7/3),P=0.046],and the donor scar score[(3.9±0.9)vs(4.2±1.3)vs(5.1±0.9),P＜0.001].[Conclusion]PAPF retrograde skin flap for the repairing soft tissue defect complicated with open ankle fracture and dislocation has advantages of few complications,more satisfactory flap appearance and better sensory function recovery.
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