[Emergency cover of open fractures of the leg. Apropos of a series of 24 clinical cases].
The authors present 24 emergency covering procedures for 24 open leg fractures: 6 free flaps and 18 pedicled flaps. The procedure was selected according to the site dimensions and topography of the defect. Topographically, the division of the leg into 3 zones: middle, upper and lower seems to be some what artificial because in practice the junction between the middle and lower segments is still a source of error in the choice of the local flap which can be used. It is preferable to use pedicled flaps in the proximal half of the tibia and free flaps in the distal half. Many failures were observed with the use of fascio-cutaneous flaps. 18 of 24 fractures were internally fixed, which allowed emergency covering. In fact, although bony covering can wait 48 hours, the presence of osteosynthesis material means that covering must be performed at the same time. This makes the plastic and microsurgical procedures easier and ensures greater patient comfort during the consolidation period and rehabilitation. The authors present their results according to the method of soft tissue coverage, their reliability, the type of osteosynthesis, the complications, number of operations and time to bony consolidation. Encouraged by their results, the authors continue with this approach.
Najean
D
D
Service de Chirurgie Orthopédique Traumatologique et Plastique, CHU Besançon, Hôpital Jean Minjoz.
Tropet
Y
Y
Brientini
J M
JM
Vichard
P
P
D004630:Emergencies; D005360:Fibula / Q000293:injuries* / Q000601:surgery; D005594:Fracture Fixation, Intramedullary; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000601:surgery; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000601:surgery*
Couverture en urgence des fractures ouvertes de jambe. A propos d'une série de 24 cas cliniques.