European Journal of Molecular & Clinical Medicine

Introduction: Coverage of open tibial fractures presents unique defects requiring the
ingenuity of the surgeon in devising flaps for stable coverage. In our country road
traffic accidents are the most common cause of lower limb trauma, followed by fall
from height. Though well established norms are in place regarding the time and nature
of cover, it requires a team effort with involvement of the orthopaedic surgeon as a rule,
and allied specialities like plastic surgeons, general surgeons
Aims: To analyzefasciocutaneous flaps reliability in coverage of open tibial fractures
Materials and methods: This study was conducted in the Department of Plastic and
reconstructive Surgery, Osmania General Hospital, Hyderabad over a period of 24
months from DEC 2019 to DEC 2021. 50 cases age group 10-60yrs of both genders who
present with open tibial fractures that are covered with fasciocutaneous flaps, small to
medium sized tissue defects of leg. Timing of coverage was classified into Acute- within
72 hours, Subacute- 3 days to 6 weeks, Chronic- Greater than 6 weeks. All the patients
included in the study were admitted to the trauma ward under the care of the attending
orthopedician and received first aid.They were then resuscitated to minimize bleeding,
restore airway and correct shock.
Results: The overall incidence of complications in this series of fasciocutaneous flaps
was 42%. Distally based fasciocutaneous flaps had a higher complication rate. major
complications, usually a failure of the intended coverage, actually more common for
proximally based flaps (12.9%) than those distally based (6.3%),although not stastically
different(p=0.436). Infection was the most common complication - 16% of all
complications. Total flap loss was seen in only 2 patients which indicated a successful
wound coverage in 96%.
Conclusion: Flap coverage is best done within 72 hours of injury. Overall early surgery
significantly reduces patient’s morbidity, decreased hospital stay and early return to
work.