DOI: 10.36347/sjams.2016.v04i06.050

Pages: 2120-2124

Open / compound fractures of the limbs are very common and challenging in this modern era of industrial and road traffic accident and is a difficult task for the orthopaedic surgeon.The aim of this study is how to minimise the morbidity, mortality, incidence of amputation and other complications of fractures by way of timely intervention with different types of flap coverage of limbs. This study was carried out in the department of orthopaedics and traumatology and department of plastic surgery - Osmania General Hospital, Hyderabad during June 1996 - Feb 1999. A total no. of 68 cases of soft tissue coverage procedures were done including different varieties of flaps like split skin grafting, fascio cutaneous, muscle, cross leg, abdominal, groin and free flaps in patients of 18 - 45 years of age group and more than 80% patients are males. In our study of 68 cases of reconstruction, 38 cases (55.8%) are carried out in the form of skin grafts, 16 cases (23.5%) are local flaps-muscle and fasciocutaneous flaps, 8 cases (11.7%) are cross leg flaps, 2cases (2.9%) are abdominal flaps, 2 cases (2.9%) are groin flaps and 2 cases (2.9%) free flaps. The grading of results are assessed based on sound union of the fracture, stiffness / range of movements of neighbouring joints, amount of scar, presence / absence of DNVD and flap necrosis. We achieved excellent results in 32 cases (47.0%), goodin 20 cases (29.4%), fair in 12 cases (17.7%) and poor in 4 cases (5.9%). It is very much useful by timely intervening and planning for soft tissue coverage in minimising the incidence of infection rate, decreasing the hospital stay and facilitating the congenial condition for further definitive management of fracture union. Flap coverage of the limbs has a most significant role in decreasing the morbidity, mortality and amputations of limbs due to infection of soft tissue and infected non unions.