Management of Post-Traumatic Composite Bone and Soft Tissue Defect of Leg

Abstract

Management of composite defects of leg following trauma requires a planned ortho-plastic approach right from the outset. Timely, planned intervention results in reduced amputation rates and improved limb salvage and function. Right from the time of presentation of the patient to the emergency with such injury, the process of decision making in terms of salvage or amputation, local flap cover/free flap cover, bone reconstruction first or soft tissue or both combined, come into play. Guidelines on management are unclear for such defects, a literature search yielding various methods being used by different authors.This article is a review of current literature on management of composite leg defects.A summary of the literature search in terms of various management options given by various authors including the rationale, advantages and disadvantages of each strategy has been provided in this article. The management protocol and method followed by the author in his institute for management of such composite defects have been described in detail. The article seeks to provide readers with an understanding of the management strategies so that appropriate method could be chosen to provide best result.

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100thbirthday of G. A. Ilizarov)

“…On the contrary, limited debridement was enough to control infection and achieve good results without radical resection in managing chronic osteomyelitis in pediatric cases[ 40 ]. Both bone transport and soft-tissue flaps were used concurrently for management of post-traumatic composite bone and soft tissue defects[ 41 ]. EF techniques were found to play a key role in the management of nonunion after Monteggia injuries[ 42 , 43 ].…”

Gait biomechanics: A clinically relevant outcome measure for preclinical research of musculoskeletal trauma

“…At current, limited effective treatment options for CTI exist. 70,71 At best, autografts are used to treat large nerve gaps, while critical bone defects are covered with transplanted muscle flaps. [72][73][74] These advancements in surgical techniques have made limb salvage possible, however, the affected individuals experience diminished function and disability long term.…”

“…At current, limited effective treatment options for CTI exist 70,71 . At best, autografts are used to treat large nerve gaps, while critical bone defects are covered with transplanted muscle flaps 72–74 .…”

Comparison of Outcome of Early Versus Delayed Hemisoleus Flap Coverage of Open Wound Over the Middle One Third of Leg after Fracture of Tibia

“…As frequency of motor bike accidents in developing countries is rising day by day so, there fracture and coverage of wound defect. Open fracture of tibia requests for skills of both 7,8 orthopedic and plastic surgeon. Soft tissue defects can be covered by flaps of microvascular 9,10 and non-microvascular types.…”