Regional fasciocutaneous flap closure for clubfoot surgery

Skin closure after a comprehensive posteromediallateral release of clubfeet through a Cincinnati incision may be difficult. This is especially true for cases of severe deformity either primary or recurrent. To deal with this, certain techniques have been developed. These consist of casting the foot in an undercorrected position with subsequent serial cast changes, leaving the incision completely or partially open for closure by secondary intention, using tissue expanders, and using different flap techniques. Five patients with nine clubfoot deformities who were treated with a comprehensive posteromedial-lateral release through a Cincinnati incision and underwent fasciocutaneous flap closure since June 1998 were included in this study. These flaps allowed correction and complete wound closure at the end of surgery without any skin tension. These flaps were constructed either in a rotational or V-Y advancement manner. None of the patients had any major complications. In summary, this new fasciocutaneous flap is a simple and reliable method in cases with primary skin-closure difficulties. It does not require special equipment or a plastic surgeon.