Middle and Long Term Follow-Up for Medial Malleolus Reconstruction and Skin Repair in Children

Objective To investigate the middle and long term clinical effect of fibular head complex tissue flap to rebuild the bone and skin defect of medial malleolus in children.Methods Nine children with bone and skin defect of medial malleolus rebuilt by fibular head complex tissue flap were followed up,the follow-up time ranged from 3.5 years to 8 years.The ankle joint function was evaluated,and the complications were effectively treated.Results All the children studied at school and attended all kinds of activities.There were no difference between their both feet,fibular head transplanted combine together with medial malleolus,and repeated fracture do not happen in the time of follow-up visit.The epiphyseal arrest did not occur for transplanted fibular head which appeared synchronous growth.Different degree epiphyseal arrest was observed at the wall inferior extremity of tibia,and lower grade strephenopodia appeared in 3 children.The lateral epiphyseal arrest was performed on a 9 year old child and wall bone graft on a 14 year old child.Functional assessment according to the American Orthopaedic Foot Ankle Society(AOFAS) rated the results as excellent in 3 cases,good in 4 cases and common in 2 cases.Conclusion The fibular head complex tissue flap to rebuild the bone and skin injury of medial malleolus is a good way in children.The complications in development process are treated in time to achieve favorable clinical effect.