Management of Soft Tissue Complications Associated with Leg Bone Injuries by Local Muscle Pedicle Flap

Background: Subcutaneous nature of tibia and poor blood supply to leg bone area causes increased complications and poor wound healing which can be managed by applying principles of plastic surgery

Aims & objectives: To evaluate the use of gastrocnemius, soleus and sural flap by orthoapedic surgeon in management of complications of open leg bone fractures i.e. exposed implants, soft tissue defects.

Material & methods: We prospectively studied 20patients with soft tissue complications in patients having both bone leg fracture. Out of which12 patients were managed by gastrocnemius flap,5 patients by soleus flap & 3 patients were treated by sural flap according to the location of the wound. Patients with age between 18-60 years with no or minimal infection, size of wound <50cm2 for middle leg and <9×12cm for lower leg were included in study. The mean follow up was of 6 months.

Results: Only two sural flap and one soleus flap had marginal necrosis. Hypoaesthesia over lateral border of foot was noted in two patients of sural flap which was not troublesome. Not any patient had developed significant functional loss. All flaps resulted in a good wound coverage with early healing.

Conclusions: Local muscle flap is efficient and easy method of treating wound defects over leg and allows an orthopaedician to manage the compound fractures comprehensively.