Cross-Leg Flaps in Reconstruction of Posttraumatic Lower Extremity Wounds in Era of Microsurgery: Institutional Experience in a Tertiary Care Centre

Introduction: Cutaneous injuries of the lower third of the leg and dorsum of the foot represent a great challenge for orthopedic and plastic surgeons. The cross-leg flap technique is a well-established method to cover soft tissue defects of lower extremity. Objectives: to review the utility of cross-leg flaps in reconstructive surgery of the lower extremity wounds Materials and Methods: A retrospective study was carried out in Department of plastic surgery of a tertiary care teaching institute in Rajasthan. Case records of 50 cases who underwent cross-leg flap for trauma or burns from 2017 to 2019 were assessed using a semi structured questionnaire for collection of data. The location of defect in the leg, the indication for cross-leg flap, the type of cross-leg flap, and perioperative complications were noted. Results: Most patients were in the age group 40 to 50 years (52.0 %). Eleven patients (22.0 %) had defect in the lower one-third of leg, followed by 10 (20.0 %) in the foot and ankle region.30 patients underwent conventional cross-leg flap while 18 patients had distally based flap. Most common reported reason was the free flap failure (32.0 %) followed by financial reasons (22.0 %). All flaps survived and Four patients (8.0 %) developed partial necrosis of the flap. Conclusion: Cross-leg flap is a safe and reliable alternative to free tissue transfer in certain situations of lower extremity trauma. Simplicity, reliability and low complication rates denote that cross-leg flap finds a definite place in reconstructive trauma surgery.