title: [About cover of ballistic wounds of distal third of leg in civilian ways].
abstract: Major causes of ballistic wounds are shooting accidents. Goals of this work are to suggest a position about ballistic wounds of leg's distal third. Reconstruction of ballistic wounds of leg's distal third is difficult, because of lack of laxity and veinous drainage in distal third; and characteristics of ballistic wounds. Ballistic traumas give a temporary cavity, which induce levelled wounds of neurovascular pedicules. We present three cases. One patient benefits from a sural flap, whereas the two others benefit respectively from a free parascapular flap and a free latissimus dorsi flap with free osseous graft. Functional results were considered as good. Treatment of ballistic wounds ask for certain specificities: 1) meticulous evaluation of wounds; 2) evaluation of vascular axis of leg. Debridments are numerous under general anaesthesia before a reconstruction with axial regional flap or free flap, which vessels are anastomosed distant. Reconstruction must be done before the tenth day.
authors.affiliation: Service de chirurgie plastique, centre hospitalier Saint-Luc-et-Saint-Joseph, 20, quai Claude-Bernard, 69007 Lyon, France. armelle.chichery@yahoo.fr
authors.forename: A
authors.initials: A
authors.lastname: Chichery
authors.forename: A
authors.initials: A
authors.lastname: Mojallal
authors.forename: L
authors.initials: L
authors.lastname: Soubirac
authors.forename: P
authors.initials: P
authors.lastname: Breton
mesh_terms: D000368:Aged; D044709:Forensic Ballistics; D006801:Humans; D035002:Lower Extremity / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D014945:Wound Healing