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Corresponding Author

Gaafar, Mohamed

Document Type

Case Series

Abstract

Background; Leg injuries frequently lead to soft tissues losses and skin defects and are commonly associated with bony fractures or even bony defects. These damages may be severe enough to be associated with major leg vessel injuries rendering reconstructive options limited. Aim and objectives; Evaluation of role of CT-angiography to expect site, extent, course, and calibre of the pedicle of distally based hemisoleus flap to make this a reliable choice for lower third leg defects. Patients and methods; This work has been conducted at the plastic surgery department Al Azhar university hospitals from Octoper 2018 till July 2021. Thirty patients are included in this study (22 male and 8 female). All patients injected with Optiray 350 (radiopaque contrast agent) and CT angiography to the affected limb was done with identification of distal pedicles to soleus and distally based hemisoleus muscle flap was done. Result; The distal soleus pedicle by CT angiography was at 6 cm above medial malleolus in 6 patients, at 6.5 cm in 6 patients, at 7 cm in 3 patients, at 7.5 cm in 2 patients, at 8 cm in 3 patients, at 8.5 cm in 1 patient, at 9 cm in 3 patients, at 9.5 cm in 2 patients and at 10 cm in 4 patients. Conclusion; In 56.7%(17 cases) accurate CT findings in relation to surgical findings, in 40%(12 cases) 0.5 cm difference, in 3.3%(1 case) 1 cm difference .So performance of angio-CT simplifies operative planning, decrease operative time, and makes operation more safe.

Keywords

CT-angiography; Hemisoleus; lower third leg defects

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