Soluzione microchirurgica alle lesioni accidentali dei piedi con un tosaerba

30 luglio, 2019

Microcirugía pie lesión motosegadora_01_20190719

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Marcelino and Lucila, patients of two and four years old. They suffer severe foot injuries after mower accidents. Dr Piñal addresses the damage in both cases with the autologous transfer of a vascularized flap of muscle gracilis, taken from the inner thigh.

Damage in both patients
Both patients have serious damage to the calcaneus, which in the case of Marcelino (left) extends to the foot as a whole .

The problem

Patients suffer grave damage to the area of the calcaneus bone. In the case of the boy, it’s an emergency intervention due to the risk of amputation, and the impact extends along the side of the foot and reaches the big toe.

Detailed view in the case of Lucila
Detailed view of the affected area in the case of Lucila, a 4-year-old patient.

The goals

The main goal of Dr Piñal is to ensure proper function in the lower extremities and restore the damage suffered, minimizing the aesthetic impact of the injuries.

Intermediate state of both procedures
In the upper combination of images, intermediate state of the procedure. On the left Marcelino, in the right image, Lucila.

The plan 

Dr. Piñal and his surgical unit design two procedures of microsurgical connection of a vascularized flap of muscle gracilis. The flap is transferred to the damaged areas with their corresponding vascular and nerval structure. Subsequently, a coverage of the affected area is performed with skin grafting.

The gracilis or internal rectus muscle originates in the lower part of the pubis and goes straight down the inner thigh, surrounding the tibial plateau in its internal segment. It only has to bear light loads.

Gracilis muscle flap harvesting
Gracilis muscle vascularized flap harvesting (Marcelino’s case).

The results

Both cases are resolved satisfactorily by preserving the function of the limb and reducing the aesthetic condition.

Postoperative aesthetic-functional results
Postoperative aesthetic-functional results. In the upper image row, Marcelino’s case, in the lower one, Lucila’s situation.