Cross-leg flap: Its role in limb salvage

Area of Science:

• Plastic Surgery
• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Free tissue transfer has largely replaced pedicled cross-extremity flaps for lower limb reconstruction.
• Difficult cases lacking suitable recipient vessels necessitate alternative reconstructive methods.
• Cross-leg flaps remain a valuable option for complex lower limb defects.

Purpose of the Study:

• To evaluate the efficacy of cross-leg flaps in reconstructing challenging lower limb defects.
• To assess the outcomes of cross-leg flaps when microvascular anastomosis is not possible.
• To determine the role of external fixator stabilization in conjunction with cross-leg flaps.

Main Methods:

• A retrospective study of 18 patients (17 male, 1 female) with Grade III B tibial fractures.
• Fasciocutaneous cross-leg flaps were utilized for reconstruction.
• External fixators were employed for limb immobilization.

Main Results:

• Fifteen flaps achieved complete viability; two had marginal necrosis, and one had superficial epidermal necrosis.
• No donor site, flap, or immobilization-related complications were reported.
• Patients regained normal gait and activity without joint stiffness.

Conclusions:

• External fixator stabilization enhances wound care and patient mobility.
• Cross-leg flaps are effective in salvaging limbs deemed nonreconstructable.
• This technique offers a reliable alternative for complex lower extremity reconstruction.