title: Experiences and lessons about soft-tissue flaps covering of severe open tibial fracture.
abstract: OBJECTIVE
  To sum up experiences and lessons ab out management of soft-tissue reconstruction in open tibial fracture over a 6-year period.
  
  
  METHODS
  Twenty-two flap reconstructions were performed to tre at soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively aft er follow up of 12-61 months.
  
  
  RESULTS
  The size of the flap ranged from 6.6 cm(2) to 28.18 cm(2) and the rate of flap failure was 13.6%. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series.
  
  
  CONCLUSIONS
  For soft tissue defect of delayed open tibial fracture Type IIIB, flap reconstruction is still an optimal option. The experiences we obtained are 1) to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; 2) to select a unilateral external fixation to provide convenience for any secondary manipulation; and 3) to use serial debridement to diminish flap failure.
authors.affiliation: Department of Orthopedic Surgery, First People's Hospital, Guangzhou 510180, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Hou
authors.forename: Z
authors.initials: Z
authors.lastname: Xu
authors.forename: Z
authors.initials: Z
authors.lastname: Su
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003646:Debridement; D016267:External Fixators; D005260:Female; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000601:surgery*