Management of the soft tissues in open tibial fractures

This paper reviews the treatment of 168 open tibial fractures referred to the Northern Ireland Plastic Surgery Service over a 15-year period. Flap reconstruction was carried out in 133 (79%) and split skin graft cover in 22 (13%). There were 18 amputations (11%). There was a high incidence of complications among early post-injury fasciocutaneous flaps and late free flaps. Twenty-five primary free flaps were transferred without complication. The current management of open tibial fractures in this Unit is described.