Reconstruction in pediatric orthopedic trauma: the role of primary cross leg flap cover

Kapadia, Abizer; Cheruvu, Ved Prakash Rao; John, Jerry R.; Tripathy, Satyaswarup; Sharma, Ramesh Kumar

doi:10.1097/bpb.0000000000000364

Cited by 8 publications

(2 citation statements)

References 15 publications

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“…Use of cross-leg flaps in the pediatric age group has been described as a simpler procedure with less chance of complications in other studies. 24 Though we do perform free flaps in pediatric age groups, in large leg defects, and very young children (under 6 years of age), finding a large donor tissue may be difficult and in such situations we found cross-leg flap to be a very useful option.…”

Section: Discussionmentioning

confidence: 92%

Review of Cross-Leg Flaps in Reconstruction of Posttraumatic Lower Extremity Wounds in a Microsurgical Unit

Mahajan¹,

Srinivasan²,

Ghildiyal³

et al. 2019

Indian J Plast Surg

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Since the advent of microsurgery, and expanding expertise in the field, extensive traumatic wounds of leg have been managed successfully with free tissue transfer. Various patient-related factors may preclude the use of free flaps even in units with available expertise and infrastructure. It is in such situations that the “cross-leg flap” comes into play. In these cases, instead of attempting complicated anastomotic techniques or anastomosis in the zone of trauma, it is better to perform the simpler and more reliable cross-leg flap. In this study, we try to show the utility of a cross-leg flap based on a retrospective study of 198 patients who underwent cross-leg flap in our institute over a period of 15 years extending from November 2003 to March 2018. Materials and methods: Case sheets of all patients who underwent cross-leg flap from November 2003 to March 2018 were reviewed. The location of defect in the leg, the indication for cross-leg flap, the pattern of cross-leg flap, and perioperative complications were noted. Results: A total of 198 patients underwent cross-leg flap for traumatic soft tissue injury of leg during this period. The most common reason for performing cross-leg flap was poor pulsatility of the recipient artery as seen intraoperatively, followed by the economics of the procedure wherein the initial cost of free flap was found significantly higher compared with cross-leg flap. All flaps survived with partial necrosis occurring in 23 patients. All flaps settled well by 2 years’ time. Bony union/fracture healing evaluation was not a part of this study. Conclusion: Cross-leg flap is still a useful tool for leg wound coverage even in microsurgical unit in situations precluding free flap coverage.

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Section: Discussionmentioning

confidence: 92%

Review of Cross-Leg Flaps in Reconstruction of Posttraumatic Lower Extremity Wounds in a Microsurgical Unit

Mahajan¹,

Srinivasan²,

Ghildiyal³

et al. 2019

Indian J Plast Surg

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“…4,5 The distally based fasciocutaneous flaps are supplied in a retrograde fashion by septocutaneous and musculocutaneous perforators of the three main vessels of the leg, the anterior tibial, posterior tibial , and the peroneal artery. 8, 13 These perforators can be localized in the lower leg with the help of hand held doppler at a distance of 2 cm, 5 cm, and 10 cm from the tip of medial or the lateral malleolus. 14,15 There are numerous causes of injury to the ankle, heel, and proximal foot.…”

Section: Discussionmentioning

confidence: 99%

Versatility of Reverse Sural Artery Flap for Coverage of Heel and Proximal Foot Defects in Children

Anwar¹,

Waheed²,

Hussain³

2021

PJMHS

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Objective: The objective of the study was to determine the versatility of reverse sural artery flap in terms of its reliability and efficacy for reconstruction of soft-tissue defects of heel and proximal foot in children. Material and Methods: A total of 30 patients aged 5-13 years with ankle and foot defects admitted to the Plastic Surgery and Burn department at the Sheikh Zayed Hospital, Rahim Yar Khan from January 2018 to July 2020 were studied by designing a retrospective cross-sectional case series study. Results: Out of 30 flaps, 26 (86.7%) healed fully, whereas 4 (13.3%) complicated by partial necrosis requiring a secondary procedure. Nineteen (63.3%) patients had wheel spoke injuries, eight (26.6%) sustained degloving injury after a road traffic accident, and three (0.1%) patients were having a history of electric burn. In 22 patients an interpolated flap was used and in 8 cases an islanded flap. Donor sites were skin grafted in all patients. Two patients developed hypertrophic scarring at donor area. All patients showed good functional results, however flap remained insensate throughout the follow-up period that was minimum for 6 months. Conclusion: The reverse sural artery flap is versatile, reliable and a method of choice in reconstructing soft-tissue defects of the hind foot in children. This flap is easy to dissect, has robust blood supply and does not sacrifice any major blood vessel of the leg. Key Words: Reverse Sural Artery Flap, children, Ankle and Foot, Soft-tissue Defects, Wheel Spook Injury

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Voetfracturen bij kinderen

Castelein¹,

Clevers²,

Kramer³

2019

Kindertraumachirurgie

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Reconstruction in pediatric orthopedic trauma: the role of primary cross leg flap cover

Cited by 8 publications

References 15 publications

Review of Cross-Leg Flaps in Reconstruction of Posttraumatic Lower Extremity Wounds in a Microsurgical Unit

Review of Cross-Leg Flaps in Reconstruction of Posttraumatic Lower Extremity Wounds in a Microsurgical Unit

Versatility of Reverse Sural Artery Flap for Coverage of Heel and Proximal Foot Defects in Children

Voetfracturen bij kinderen

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