Abstract
Background: Lower limb defects following compound fractures are a major cause of morbidity following trauma. Local reconstructive options are often limited necessitating microvascular free flap reconstruction.
Materials and Methods: A retrospective evaluation of all patients undergoing microvascular free flap reconstruction for post-traumatic lower limb defects from January 2011 to December 2014 at a tertiary health care centre was performed. All patients were evaluated for etiology, site of the defect, free flap used, recipient vessel, type of anastomosis, flap survival and post-operative complications.
Results: Of all the 22 patients evaluated with a mean age of 27.7 years (range 8-66 years), 18 were males and 4 females. Road traffic accident was the major mode of trauma (18 patients) followed by railway accident (2), fall from height (1), assault (1). Flaps used were ALT flaps (14), Latissimus Dorsi (6), gracilis (2). Most common site of defect was lower third leg (15) followed by middle third leg (2), foot and sole (5). Fasciocutaneous flaps were done in 14 patients and muscle flaps were done in 8 patients. The overall survival rate was 90.90% (20/22) with partial necrosis in 2 patients. End to end anastomosis was done in 18 patients and end to side anastomosis was done in 4 patients.
Conclusions: Microvascular free flaps are an integral part of treatment for post-traumatic lower limb defects. Excellent outcomes can be achieved by thorough debridement, appropriate recipient vessel and flap selection and careful post-operative management.
Keywords: Lower limb defects, free flap, muscle flaps, fasciocutaneous flaps.
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Corresponding Author
Dr Amarnath Munoli
4th Floor Room Number 450 College Building Department of Plastic Surgery Sion Hospital Mumbai 400022
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.75
