Modification of External Fixator in Cross-Leg Flap: A Stabilizing Solution for an Optimal Outcome

Area of Science:

• Orthopedic Surgery
• Plastic and Reconstructive Surgery

Background:

• Reconstructing lower limb defects with compromised blood supply is challenging.
• Cross-leg flaps are a viable salvage option but require prolonged limb immobilization.
• Conventional methods risk flap necrosis and patient discomfort due to shearing forces and immobility.

Purpose of the Study:

• To describe a modified external fixator for cross-leg flap procedures.
• To enhance limb stabilization and prevent flap complications.
• To improve patient comfort and ease of wound management.

Main Methods:

• Retrospective assessment of eight patients undergoing cross-leg flap reconstruction for post-traumatic leg defects.
• Application of a modified external fixator with an additional tubular rod at the base.
• Evaluation of flap survival, complications, and wound healing.

Main Results:

• All eight patients were male with post-traumatic defects; average age was 41.
• The modified external fixator successfully stabilized the limbs and prevented maceration.
• All flaps survived, with two cases experiencing manageable distal margin necrosis.

Conclusions:

• External fixators are effective for stabilizing limbs during cross-leg flap reconstruction.
• The described modification prevents maceration and improves airflow, enhancing flap viability.
• This technique offers a reliable solution for complex lower limb reconstructions.