Serratus anterior muscle transplantation for the repair of soft tissue defects in foot and ankle / 中华骨科杂志

ABSTRACT

Objective To explore serratus anterior muscle transplantation for the repair of soft tissue defects in foot and ankle. Methods Seventeen patients consisted of 11 males and 6 females aging from 13 to 58 years with the mean age of 35.2 years. The anatomical parameters of serratus anterior of 17 cases were measured, the thickness of the muscle was (1.24?0.65) cm, and the diameter of origin point of the nutrient artery to the muscle was (1.4?0.6) mm. There were two veins arising from the muscle, the diameter of larger one was (2.5?0.8) mm. The length of vascular pedicle was (8.31?1.48) cm. 17 patients with soft tissue defect of foot and ankle were treated with free serratus anterior muscle transfer and split skin graft overlying the muscle. The primary lesions were soft tissue defect around the ankle and Pilon fracture in 5 cases, non-union of distal tibial fracture in 3, Achilles tendon and soft tissue defect in 3, metatarsal fracture and soft tissue defect in 4, and calcaneal fracture with soft tissue defect in 2. All of the patients suffered from infection or exposure of bone or applied plate, the area of soft tissue defect ranged from 4.5 cm?6 cm to 11 cm?13 cm. Results The average operative time was (6.5?1.2) hours. The complications included local hematoma in 2 cases, superficial infection in 2, winged scapula without function loss in 1,scar pain in 2, and numbness of lateral thoracic wall in 1. Furthermore, weakness and decreased shoulder mobility were noted in 3 patients comparing with the contralateral side, but the condition improved half year following the operation. The transferred muscle flap appeared thinner and less bulky , and healed intimately with the adjacent foot tissue, the patients resumed good function in walking. Conclusion The serratus anterior muscle flap is a good choice for treatment of soft tissue defects in foot and ankle.