Abstract: Aim: To study and analyse various management options of middle one third leg defects.
Methodology: This Prospective Clinical study conducted in the department of Plastic and Reconstructive surgery, Osmania General Hospital, Hyderabad, Telangana includes 30 cases of middle one third of leg defects admitted between November 2016 to November 2018.
Results: Age of the patients ranged between 20 and 60 years with a mean age of 34years. 27 patients were males and 3 were females. 18(60%) patients had middle one third defects of right leg and 12(40%) patients had middle one third defects of left leg. Leg defect was on anteromedial site in 21(70%) patients and anterolateral site in 9 (30%) patients. Trauma (Road traffic accidents) was the cause in 26 (86.6%) patients and post operative defect exposing Implant in 3(10%) patients. The size of the defect ranged from 4 sq.cm to36sq.cm. Time of presentation to hospital ranged from less than 1week to 1year after injury. Tibia was the common component exposed in all patients. Associated Grade III B compound fractures with external fixator were present in 18(60%) patients. Minor complications were seen in 4(13.3%) patients. Partial Graft loss was present in 1 patient (3.3%) over flap donor site which was managed conservatively. Flap tip necrosis (1cm) was present in 3 patients which was debrided and grafted. The follow up period was up to six months with adequate physiotherapy. In most of the cases, satisfactory results with good aesthetic appearance was present.
Conclusion: There are many related advantages of this flaps such as being a simple technique allowing full tissue coverage in a one‑stage operation, and it is present in the dissection field. Full tissue coverage, functional recovery, and good esthetic results are achieved with minimum damage to the donor site. In addition, the surgical procedure is relatively short and easy to perform, and it does not require microsurgical skills and instruments.
