Open AccessSoft tissue coverage in open fractures of tibia
Author(s) -
Jagannath B Kamath,
Mahabalesh Shetty,
Thangam Verghese Joshua,
Ajith Kumar,
Harshvardhan,
Deepak M. Naik
Publication year - 2012
Publication title -
indian journal of orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.434
H-Index - 33
eISSN - 1998-3727
pISSN - 0019-5413
DOI - 10.4103/0019-5413.97265
Subject(s) - medicine , surgery , tibia , soft tissue , debridement (dental) , orthopedic surgery , external fixation , internal fixation , bony union , fixation (population genetics) , external fixator , population , environmental health
The treatment of Gustilo Anderson type 3B open fracture tibia is a major challenge and it needs aggressive debridement, adequate fixation, and early flap coverage of soft tissue defect. The flaps could be either nonmicrovascular which are technically less demanding or microvascular which has steep learning curve and available only in few centers. An orthopedic surgeon with basic knowledge of the local vascular anatomy required to harvest an appropriate local or regional flap will be able to manage a vast majority of open fracture tibia, leaving the very few complicated cases needing a free microvascular flap to be referred to specialized tertiary center. This logical approach to the common problem will also lessen the burden on the higher tertiary centers. We report a retrospective study of open fractures of leg treated by nonmicrovascular flaps to analyze (1) the role of nonmicrovascular flap coverage in type 3B open tibial fractures; (2) to suggest a simple algorithm of different nonmicrovascular flaps in different zones and compartment of the leg, and to (3) analyze the final outcome with regards to time taken for union and complications.