Limb Reconstruction

Traditionally in reconstruction of lower limb soft tissue defects, muscle flaps have been the ‘Gold Standard’ for Gustillo Anderson Grade III B fracture involving upper and middle third defects. Lower third defects were usually reconstructed with free flaps. Evolution in flap surgery has enabled fasciocutaneous, adipofascial and super thin flaps to be harvested for the purpose of reconstruction thereby minimizing morbidity from muscle inclusion into the flap. We present our experience with perforator (propeller) flaps for reconstruction of soft tissue defects in the lower limb. propeller flaps is a versatile option for reconstruction of lower leg soft tissue defects with associated Grade IIIB open fractures. reconstructive surgeon must be able to utilize these perforator flaps in reconstructive surgery, then he/she needs to be familiar with the structural anatomy and vascular anatomy of the area involved as it provides a framework for flap elevation. The characteristic anatomy of parent tissue in the lower third of the leg is particularly thin, fasciocutaneous with limited underlying muscle. For this reason free flap or pedicled flap reconstruction with tissue from more proximal regions of the body are anatomically and aesthetically not very suitable for reconstruction of the distal third of the leg. Bulky tissue from the thigh (e.g. Anterolateral Thigh Free Flap-if inadequately thinned) and proximal regions of the leg (Reverse Sural Flap) are large flaps which do not aesthetically fit the reconstructed area and maybe functionally inappropriate. Propeller Flaps in Lower Limb Reconstruction: Case Series: Ramesh Sasidaran, Mohd Ali Mat Zain and Normala Hj Basiron and Sergius Ajik

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Last date updated on April, 2024