Reconstruction of total calcaneus gunshot defect with a free V-shaped iliac bone flap

The hindfoot bears 80% of the body’s weight and provides a springy connection between the forefoot and the entire foot. Correction of hind-foot defects is a difficult objective, as it is associated with the need to restore the lost bone, soft tissues and connection of calcaneus with flexor muscles of the foot. In this article, we present clinical and radiological results of a new method for correction of total gunshot defect of cal-caneus using a V-shaped iliac bone graft with skin platform and anterolateral thigh fasciocutaneous flap. Extensive hindfoot defect included total calcaneus defect, skin defect of plantar, posterior and lateral parts of the foot. We used surgical templates prepared by using of 3D tech-nologies. Another feature of this case is inclusion of iliac bone graft in the distal end of vascular pedicle of anterolateral thigh fasciocutaneous flap. Four months later, CT revealed signs of consolidation of the graft fragments between themselves and foot bones. External fixator was re-moved. The goal of reconstructive surgery of calcaneus is restoring appropriate anatomical structures and creating conditions for the first phase of walking cycle, i.e. stepping on the heel and redistributing body weight on the entire foot. Various autologous, allogeneic and artifi-cial plastic materials are used. In contrast to these techniques, V-shaped iliac crest graft makes it possible to restore not only height of calca-neus, but also width of its supporting surface. Moreover, we avoid the risk of complications in the donor area following transcendental size of iliac bone graft. The proposed technique provides effective correction of extensive hindfoot defects and total defects of calcaneus resulting from gunshot and mine-explosive wounds. © 2023, Media Sphera Publishing Group. All rights reserved.