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Articles linked to this work by shared authors, journal, and citation graph.

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Fix or Fuse: The Lisfranc Debate Persists: Commentary on an article by Wolfram Grün, MD, et al.: "Primary Arthrodesis Versus Temporary Bridge Plating in Unstable Lisfranc Injuries. A Concise Follow-up, at 10 Years, of a Previous Report".

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Related Experiment Video

Updated: Mar 28, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Soft Tissue Reconstruction After Total Ankle Arthroplasty.

Christopher E Gross1, Ryan Garcia2, Samuel B Adams3

  • 1Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA cgross144@gmail.com.

Foot & Ankle International
|December 22, 2015
PubMed
Summary

Flap reconstruction effectively salvages total ankle replacements (TAR) with wound complications. This approach improves implant survival and patient function, despite some flap failures.

Keywords:
flapstotal ankle arthroplastywound management

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Microsurgery

Background:

  • Wound complications after total ankle replacement (TAR) can lead to severe outcomes, including infection and implant failure.
  • Soft tissue coverage using flaps is crucial for protecting the prosthesis and tendons, preventing a cascade of complications.

Purpose of the Study:

  • To investigate the success and complication rates of flap reconstructions for soft tissue defects following total ankle arthroplasty.
  • To evaluate the impact of flap coverage on wound healing, implant survival, and functional outcomes in patients undergoing TAR.

Main Methods:

  • Retrospective review of 1001 primary total ankle replacements (TARs) performed between 1998 and 2014.
  • Identification of 19 patients requiring secondary flap surgery for soft tissue defects not amenable to skin grafting.
  • Analysis of secondary procedures, wound healing, complications, and implant failure rates, with a mean follow-up of 24.1 months post-flap.

Main Results:

  • Nineteen patients underwent 44 procedures for wound issues (1.9% of TARs), with a mean time to flap of 13.1 weeks post-TAR.
  • The most common indication was non-healing anterior wounds; sural pedicle and propeller flaps were frequently used.
  • Flap failure occurred in 21.1% of cases, leading to two amputations; however, successful flaps improved functional scores (AOFAS, VAS, MSK-FAI).

Conclusions:

  • Flap reconstruction, managed by microsurgeons, is vital for salvaging total ankle replacements (TARs) with significant soft tissue defects.
  • Employing various flap techniques can improve implant survival and retention rates after TAR complications.
  • Successful flap coverage leads to significant functional improvements in patients with post-TAR wound issues.