Extremity preservation in traumatic and nontraumatic lower extremity defects

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Lower extremity reconstruction addresses diverse defects from trauma, infection, and tumors.
• Flap surgery remains a critical yet challenging aspect of reconstructive procedures.
• Advancements in plastic surgery continue to refine techniques for limb salvage.

Purpose of the Study:

• To compare the efficacy of local flap surgeries versus microsurgical free flaps for lower extremity reconstruction.
• To analyze postoperative complications and limb preservation rates associated with each flap type.
• To identify factors influencing flap selection in complex lower extremity defects.

Main Methods:

• A retrospective study of 187 patients treated at a tertiary care hospital.
• Analysis of defects with traumatic (29.4%) and nontraumatic (70.6%) etiologies.
• Collection of patient data, flap selection, and postoperative complications over a 12-month follow-up.

Main Results:

• 104 free flaps and 83 local flaps were performed.
• Latissimus dorsi and gracilis were common free flaps; gastrocnemius, soleus, and plantaris medialis were common local flaps.
• An overall limb preservation rate of 92.5% was achieved, with no significant difference between flap groups.

Conclusions:

• Both local and free flap techniques are viable for reconstructing complex lower extremity wounds.
• Effective limb preservation is achievable with both reconstructive methods.
• Flap selection is guided by defect location, size, and individual patient factors.