Summary
In a period of 5 1/2 years, the use of 43 free flaps in the treatment of severe lower leg trauma was reviewed. The majority of the patients had severe tibial fractures with extensive soft tissue loss and severe contamination. One flap failed in the early group, 3 in the delayed group. There were no flap failures in the late group. The postoperative infection rate was the highest in the subacute group. Hospital stay and bony healing time were directly related to the timing of free flap surgery. Referral difficulties causing delay in free flap surgery, timing of free flap surgery, donor vessel quality and patient follow-up are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Byrd HS, Spicer TE, Cierney G (1985) Management of open tibial fractures. Plast Reconstr Surg 76:719–730
Godina M (1986) Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg 78:285–292
Gustilo RB, Mendoza RM, Williams DN (1984) Problems in the management of type III open fractures. A new classification of type III open fractures. Trauma 24:742–746
Irons GB (1990) An overview: indications for complex skin coverage in the lower limb. Microsurgery 11:48–53
Masquelet AC, Augereau B, Apoil A, Nordin JY (1987) Traitement des fractures complexes de jambe par lambeaux musculaires de recouvrement, pédicules ou libres et apport osseux complementaire. Rev Chir Orthop 73:117–121
Oberlin C, Duparc J, Alnot JY, Huten D (1986) Traitement des pertes de substance cutanée des fractures ouvertes de jambe de type III. Chirurgie 112:668–673
Reath DB, Taylor JW (1989) Free rectus abdominis muscle flap: advantages in lower extremity reconstruction. South Med J 782:1143–1146
Seyfer AE, Lower R (1989) Late results of free muscle flaps and delayed bone grafting in secondary treatment of open distal tibial fractures. Plast Reconstr Surg 83:77–84
Velaczo A, Fleming LL, Foad Nahai (1983) Soft tissue reconstruction of the leg associated with the use of the Hoffmann external fixator. J Trauma 23:1052–1057
Yakuboff KP, Stern PJ, Neale HW (1990) Technical successes and functional failures after free tissue transfer to the tibia. Microsurgery 11:59–62
Yaremchuk MJ (1986) Acute management of severe soft tissue damage accompanying open fractures of the lower extremity. Clin Plast Surg 13:621–629
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Boeckx, W., Blondeel, P.H., Van Raemdonck, D. et al. The use of free flaps in the treatment of severe lower leg trauma. Eur J Plast Surg 15, 63–68 (1992). https://doi.org/10.1007/BF00178568
Issue Date:
DOI: https://doi.org/10.1007/BF00178568