A Comparative Study of Soft Tissue Cover in Compound Lower Limb Trauma at an Interval of a Decade

INTRODUCTION Compound lower limb trauma needs to be covered with flaps. The defects of lower limb are divided into upper, middle and lower third defects. Different flaps are described based on the site of the defect. AIM To study the pattern of compound lower limb trauma and the flap options for different defects of the leg at an interval of a decade. MATERIAL AND METHODS 32 patients with compound lower limb trauma were given flap cover between 2002 and 2005. Another 82 cases have been given flap cover between 2012 and 2015. Comparison of the pattern of compound limb trauma and flap cover is done. DISCUSSION For upper third leg defects, Gastrocnemius muscle and myocutaneous flaps have been the workhorse then, a decade ago and it is the same now. Propeller & Transposition flaps have been tried in the recent past. For middle third defects, Gastrocnemius myocutaneous, Soleus, Transposition, Cross leg and free flaps were used, while for lower third defects Reverse Sural artery, Fascio-cutaneous and Free flaps are commonly used. Use of Propeller and free flaps are on the rise now. CONCLUSIONS Propeller flaps are an alternative for free flaps in middle and lower third defects in set-ups with infrastructural and human resources constraints. Vastus lateralis as a free flap can be a reasonable alternative in delayed cases.