Abstract: Objective   To investigate the feasibility and efficacy of descending branch of lateral circumflex femoral artery Flow-through flap combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) in the emergency treatment of Gustilo type IIIC fracture of tibiofibula.    Methods    A retrospective analysis was performed on 6 patients with Gustilo IIIC fractures of tibiofibula admitted to our department from October 2019 to September 2020, including 5 males and 1 female.  The age ranged from 24 to 54 years, with an average of 35 years.  Causes of injury: 4 cases of traffic accidents, 1 case of falling, 1 case of heavy objects.  Limb severity score: more than 7 scores in 2 cases, 6-7 scores in 3 cases, less than 7 scores in 1 case.  All patients were accompanied by skin and soft tissue defects with an area of 15 cm×7 cm to 28 cm×12 cm. All patients were treated with the flow-through flap of descending branch of lateral circumflex femoral artery combined with MIPPO.   Results    The hospitalization time of patients in this group was 10 to 20 days, with an average of 14.2 days.  All flaps survived successfully in stage I.  All patients were followed up for 7-12 months, with an average of 10.1 months.  During the follow-up period, there were no complications such as bone infection and osteomyelitis, and the bone healing time was 7-9 months, with an average of 8.3 months. The skin flap was of good color and texture, and there were linear scars in the donor site. The limbs were in good shape and functional satisfaction (no pain, good sensory recovery, weight-bearing walking, and no obvious lameness).    Conclusions   The flow-through flap with the descending branch of lateral circumflex femoral artery combined with MIPPO in emergency treatment of Gustilo IIIC fracture of tibiofibula can significantly shorten the treatment period, reduce complications, clear fresh wound anatomy and simpler operation, which is conducive to the early recovery of limb function.  

Key words: Anterolateral thigh flap; ,  Flow-through flap; ,  Emergency; ,  Internal fixation; , Fracture, Microsurgery technology