[A new combined local transferable flap technic for closure of pretibial soft tissue defects]

The cross-leg flap is a well established and recommendable procedure although it has disadvantages, like fixation in uncomfortable position, three or four weeks of bed rest and injury to the donor leg. With diseased or missing donor leg the procedure is impossible. This also is the case if the patient refuses the operation because of the uncomfortable fixation. As alternative procedure for these cases we developed a combined local flap procedure. It consists of a subfascial mobilized dorsolateral rotated flap and a subfascial mobilized dorsomedial doublebased flap; both are adapted without tension over the defect. The procedure proved to be efficient. Posttraumatic soft tissue defects with exposed osteosynthetic material were closed, cases of long standing osteitis with skin ulcerations were treated successfully after en-bloc-resection of the infected skin and bone region. The advantages of this procedure: early mobilization of the patients, shortening of treatment, non-affection of the opposite leg, non-irritated, resistant, well-cushioned and innervated soft tissue coverage as well as cure of the osseous infection.