An analysis of post traumatic leg and foot defects


  • Gopalan G. Department of Plastic Surgery, Govt. Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India
  • Dhanaraju S. Department of Plastic Surgery, Govt. Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India



Age, Fasciocutaneous flaps, Trauma, Sex


Background: Management of lower extremity trauma with bone and soft tissue injury is a challenging task with the aim of giving early recovery and durable good quality skin cover according to the skin defect and analyze various reconstructive options at various levels of injury. Our aim of the study is to analyze various reconstructive options for traumatic skin loss involving lower limbs especially knee and below knee, and analyze the incidence of age, sex and etiology of traumatic defects.

Methods: Prospective study in our plastic surgery department in the period of 24 months, with all the cases of traumatic defects of leg and foot where included. All age and sex patients were included.

Results: Most common cause for traumatic leg and foot defects are road traffic accidents followed by accidental fall and others, most commonly in males amounting 73%, children 10% and  females 17%, among the skin and soft tissue  defects upper and lower 1/3 leg defects are predominant. Among the soft tissue coverage split thickness skin graft dominating about 60% of cases, flaps 30% of cases, among the flaps 70% are fasciocutaneous flaps predominantly inferiorly based  and 30% are muscle and musculocutaneous flaps, among the muscle predominantly soleus muscle flap was used to cover the defect.

Conclusions:Road traffic accidents dominating the cause for leg and foot defects , males are more commonly affected  and upper one third leg defects are predominant for soft tissue coverage split thickness skin graft are commonest procedures followed that cutaneous and muscle flaps.



Amgwerd MG, Trentz O, Schutz K, Meyer V. Concept for the management of combined bone-soft tissue defects of the lower extremity. Swiss Surg. 1995;(2):90-5.

Kinzl L, Sugar G, Stober R. convering soft tissue defects. Der Unfallchirurg. 1996;99(10):714-26.

Kozarski J, Jevtović D, Hadzić Z, Panajotović L, Novaković M. Reconstructive methods in the treatment of soft tissue defects below the knee. Vojnosanitetski pregled. 2000;57(2):163-70.

Hersh CK, Schenck RC, Williams RP. The versatility of the gastrocnemius muscle flap. Am J Orthop. 1995;24(3):218-22.

Hyodo I, Nakayama B, Takahashi M, Toriyama K, Kamei Y, Toril S. The gastrocnemius with soleus bi-muscle flap. Br J Plast Surg. 2004;57(1):77-82.

Sharma GN, Nepram SS. Sural artery flap: a dependable solution in lower leg and foot soft tissue reconstruction. Inter Surg. 2001;86(3):144-50.

Liu X, Kuang X. The clinical application of cross-leg flaps for coverage of bone exposure on the leg. Zhonghua zheng xing wai ke za zhi= Zhonghua zhengxing waike zazhi= Chinese journal of plastic surgery. 2002;18(6):346-7.

Koshima I, Nanba Y, Tsutsui T, Takahashi Y, Itoh S. Perforator flaps in lower extremity reconstruction. Handchir Mikrochir Plast Chir. 2002;34(4):251-6.

Kuntscher MV, Erdmann D, Homann HH, Steinau HU, Levin SL, Germann G. The concept of fillet flaps: classification, indications, and analysis of their clinical value. Plast Reconstr Surg. 2001;108(4):885-96.

Attinger CE, Ducic I, Cooper P, Zelen CM. The roll of intrinsic muscle flaps of the foot for bone coverage in foot and ankle defects in diabetic and nondiabetic patients. Plast Reconstr Surg. 2002;110(4):1047-54.

Bumbasirevic M, Stevanovic M, Lesic A, Atkinson HD. Current management of the mangled upper extremity. Inter Orthop. 2012;36(11):2189-95.

Artiaco S, Battiston B, Colzani G, Bianchi P, Scaravilli G, Boux E, et al. Perforator based propeller flaps in limb reconstructive surgery: clinical application and literature review. BioMed Res International. 2014;2014.

Bajantri B, Bharathi RR, Sabapathy SR. Wound coverage considerations for defects of the lower third of the leg. Indian journal of plastic surgery: official publication of the Association of Plastic Surgeons of India. 2012;45(2):283.






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