Abstract: Objective To analyze the application effect of anterolateral femoral free flap transplantation based on three-dimensional reconstruction in CT angiography in the treatment of chronic osteomyelitis of the foot and ankle complicated with soft tissues defect.Methods A retrospective analysis was conducted on the clinical data of 105 patients with chronic osteomyelitis of the foot and ankle complicated with soft tissues defect who were admitted to Suining Central Hospital in Sichuan Province from January 2020 to January 2023.Patients enrolled were divided into the control group (n=52) and the observation group (n=53) according to different perforating blood vessel examination methods before surgery.The control group underwent anterolateral femoral free flap transplantation based on handheld Doppler ultrasound,while the observation group underwent anterolateral femoral free flap transplantation based on CTA three-dimensional reconstruction technology.Comparison between the groups was made on inflammatory factors (CRP,TNF-α and IL-6),skin flap repair effect,foot and ankle function (AOFAS) score,flap sensation,survival rate of skin flaps,and the incidence of adverse events.Results On day 14 after operation,serum CRP,TNF-α and IL-6 levels in the observation group were lower than those in the control group (P<0.05).Six months after operation,the effect of flap repair in observation group was better than that in control group,and the survival rate of flap was higher than that in control group (100.00% vs 92.31%) (P<0.05).Twelve months after operation,AOFAS score and flap sensation score of the observation group were higher (P<0.05).The incidence of adverse events was lower in the observation group than in the control group (3.77% vs.15.38%) (P<0.05).Conclusion Anterolateral femoral free flap transplantation based on CTA 3D reconstruction technique can repair soft tissue defect and reduce the risk of adverse events while can cure chronic osteomyelitis.

Key words: chronic osteomyelitis, soft tissues defect, three-dimensional reconstruction in CT angiography, anterolateral femoral free flap transplantation