Fasciocutaneous flap closure of a grade III lower third tibial fracture: an alternative to free flap coverage.
We present a patient who sustained a close-range shotgun wound resulting in a grade III fracture of the lower tibia. The wound was debrided on several occasions and, on day 4, was closed with a flexor digitorum muscle and pedicled fasciocutaneous flap. Grades III and IV lower one-third tibial fractures generally require a free flap to accomplish stable soft-tissue coverage. Free-tissue transfer, however, remains a tedious and lengthy procedure. Occasionally a fasciocutaneous flap may be available to facilitate wound closure and spare the patient a lengthy procedure and distant donor site. The established principles of compound tibial coverage must be adhered to when choosing a local fasciocutaneous flap.
Marks
M W
MW
Section of Plastic and Reconstructive Surgery, University of Michigan Medical Center, Ann Arbor.
Butler
J C
JC
D000328:Adult; D006801:Humans; D008297:Male; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000601:surgery*; D014948:Wounds, Gunshot / Q000601:surgery