Clinical evaluation of orthoplastic limb salvage protocol using anterolateral femoral free flap and kickstand fixation: A retrospective case-control study.

[PURPOSE] To evaluate the clinical outcome of orthoplastic limb salvage approach for the management of diabetic foot ulcers (DFUs).

[METHODS] Patients with DFUs who received treatment at the Peking University Shenzhen Hospital between January 2019 and June 2024 were analyzed. All patients received standard of care, including surgical wound debridement and revascularization, and were followed up for 6 months. Patients were divided into two different wound closure strategies: anterolateral thigh free flap transfer and Kickstand external fixation (n = 24; ALT group) and regular wound dressing (n = 24; control group).

[RESULTS] The ALT group exhibited a 50 % faster healing rate compared to the control group (33.7 ± 19.9 days versus 69.29 ± 23.5 days; P < 0.001). The flap success rate was 91.7 %, with two instances of flap necrosis (8.3 %) necessitating revision. The mean 6-month AOFAS score in the limb salvage group (90.8 ± 6.2) was significantly greater than that of the control group (85.8 ± 7.7; P = 0.017). No reports of hardware infection were noted.

[CONCLUSION] The orthoplastic limb salvage approach integrates concepts from both orthopedic and plastic surgery. The incorporation of Kickstand fixation techniques mitigates flap complications and expedites wound healing. Consequently, patients experience improved quality of life, which enable them to return to their daily activities more quickly.