Local-advancement soft-tissue coverage in a child with ipsilateral grade IIIB open tibial and ankle fractures

This case describes the successful treatment of a child with a vascular injury and two ipsilateral grade IIIB open lower leg fractures using two local-advancement soft-tissue techniques. Multiple relaxing skin incisions were used for closure of the wound associated with the patient's midshaft tibial fracture, whereas a randomly patterned rotational fasciocutaneous flap was used for coverage of the wound associated with the patient's medial malleolar fracture. These straightforward local-advancement soft-tissue coverage techniques allowed for treatment of a child with vascular injuries, ensuring the viability of the foot, while preventing distant donor site morbidity and functional sacrifice. Additionally, no special microsurgical or specialty training is necessary to achieve a similar result.