Study of Various Modalities of Management of Lower One-third Leg Defects in a Tertiary Care Hospital

Abstract

Background: Lower extremity reconstruction is essential to plastic surgery and focuses on treating wounds and defects secondary to trauma, cancer, or chronic disease processes. Anatomical features of the lower third of the leg like subcutaneous bone surrounded by tendons with no muscles and vessels in isolated compartments with little intercommunication between them make the coverage of the wounds in the region a challenging problem. Aim: to study the various modalities of surgical management of lower 1/3rd leg defects. The study also aims to study the defect size and region in planning various flaps possible in the reconstruction ladder. Methods: The study was conducted from September 2014 to June 2017 on patients admitted to the Department of Burns, Plastic & Reconstructive Surgery and referred patients from the Department of General Surgery & Orthopaedic Surgery, S C B Medical College & Hospital, Cuttack. The Study includes all lower 3rd Leg defect varieties for different surgical treatment modalities. Results: Various reconstructive methods were used to cover the lower 1/3rdleg defects; the maximum was the free muscle transfer in 9 cases. The following typical flap used was the reverse sural flap. Conclusion: The goal in lower limb reconstruction involves needing a stable skeleton, allowing weight-bearing status, with adequate soft tissue coverage to nourish and protect the underlying bone. What one would use for reconstruction depends upon the surgeon’s familiarity and comfort levels with the technique as much as the various circumstances.