A hybrid therapy for Buerger's disease using distal bypass and a free temporoparietal fascial flap: a case report.

Abstract

Buerger's disease presents a difficult challenge, with its uncertain etiology and lack of a standardized therapy, and is often refractory to treatment. In the present report, we have described the case of a 43-year-old male with Buerger's disease, a refractory ulcer on his right great toe, and severe pain at rest. We obtained favorable results using a hybrid therapy that combined distal bypass with a free temporoparietal fascial flap. Postoperatively, the flap healed, and the patient's pain resolved. After more than 3 years of follow-up, he had had no recurrence of the foot ulceration, and the patency of the bypass graft had been confirmed using Doppler flowmetry. We believe that the hybrid therapy we devised for the present patient (ie, combined distal bypass with a free temporoparietal fascial flap) is an effective treatment of Buerger's disease with pedal ulceration. The therapeutic strategies for this condition should not adhere to a single treatment modality; rather, they should combine available treatment modalities according to each individual patient's condition.

• Authors: Rie Iwasaki, Hisashi Motomura, Takaharu Hatano, Daisuke Sakahara, Naho Fujii, Shinobu Ayabe
• Journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons (J Foot Ankle Surg) 2014 May-Jun Vol. 53 Issue 3 Pg. 312-5 ISSN: 1542-2224 [Electronic] United States
• PMID: 24613785 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Blood Vessel Prosthesis Implantation
• Foot Ulcer (surgery)
• Hallux
• Humans
• Limb Salvage
• Male
• Microsurgery
• Peripheral Arterial Disease (surgery)
• Saphenous Vein (transplantation)
• Surgical Flaps (blood supply)