fa تخصصي Special مقالات اصيل Original Article <strong>BACKGROUND</strong><br> Eradication of chronic tibial osteomyelitis necessitates aggressive debridement often followed by soft tissue reconstruction. Muscular flaps are said to be more effective than non-muscular flaps for infection treatment, while fasciocutaneous and perforator flaps are considered being less invasive and offering a better aesthetic result.<br> <strong>METHODS</strong><br> In this study we reviewed 24 consecutive cases of chronic tibial osteomyelitis treated according to a specific protocol in a tertiary hospital. Soft tissue coverage was done with either muscular or non-muscular free flaps. Infection recurrence and complications were compared between different flap types. Additionally, we assessed the long-term functional and aesthetic results and patient&rsquo;s satisfaction.<br> <strong>RESULTS</strong><br> Muscular flap was used in 13 patients (13 latissimus dorsi and 1 serratus anterior) and 11 patients underwent fasciocutaneous / perforator flaps (1 anterolateral thigh flap, 4 lateral arm flaps, 5 thoracodorsal artery perforator (TAP) flaps and 1 radial forearm flap).<br> Infection was resolved for 84.6% of patients in the muscular flaps group and 90.9% in the non-muscular flaps group. None of the patients with muscular flaps were satisfied with the aesthetic appearance of their reconstructed leg compared to 83.3% of patients with non-muscular flaps. Also a slight regain of touch sensitivity was acknowledged in the non- muscular flap group compared to the muscular.<br> <strong>CONCLUSION</strong><br> In this study of adult chronic tibial osteomyelitis cases, we demonstrated that fasciocutaneous and perforator free flaps offer a comparable efficacy to the muscle flaps for infection treatment, with a significantly higher patient satisfaction and aesthetic result. Inferior limb, Chronic osteomyelitis, Free flap, Reconstructive surgery, Microsurgery 294 300 http://wjps.ir/browse.php?a_code=A-10-384-2&slc_lang=fa&sid=1 Pablo Buono 10031947532846005832 10031947532846005832 Yes Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland Pascal Castus 10031947532846005833 10031947532846005833 No Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland Victor Dubois-Ferrière 10031947532846005834 10031947532846005834 No Orthopaedic Surgery Department, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland Eva Meia Rüegg 10031947532846005835 10031947532846005835 No Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland Ilker Uçkay 10031947532846005836 10031947532846005836 No Unit of Infectious Diseases, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland Mathieu Assal 10031947532846005837 10031947532846005837 No Orthopaedic Surgery Department, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland Brigitte Pittet-Cuénod 10031947532846005838 10031947532846005838 No Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland Ali Modarressi 10031947532846005839 10031947532846005839 No Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland