The place of the cross-leg flap in reconstructive surgery of the lower leg and foot: A review of 165 cases

Morris, A.M.; Buchan, Alice

doi:10.1016/s0007-1226(78)90064-4

Cited by 61 publications

(27 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most patients with sensory skin grafts to the free muscle flaps do not completely recover normal sensation but usually can "sense" a protective, deep sensation of pressure. 5 This condition can be observed in pedicled as well as free flaps, 42,43 and is attributed to the perception of sensation through deeper structures underlying the grafts or flaps, such as the skeletal muscle. Moberg 44 suggested that on a daily basis, there is no conscious use of these afferents in muscle sense.…”

Section: Discussionmentioning

confidence: 99%

Assessment of muscle flap sensibility by evoked potentials in the rat

Siemionow

Latıfoǧlu²,

Demirkan³

et al. 2000

Microsurgery

View full text Add to dashboard Cite

This study investigated whether the sensory-to-motor reinervation of the muscle flap provides a better sensory recovery of an overlying skin graft. Fifty-four animals were studied in three groups of 18 rats each: group I (control): 1 cm of the gastrocnemius muscle motor nerve was excised and no repair was performed; group II (motor-to-motor repair): the motor nerve of the gastrocnemius flap was transected and repaired; group III (sensory-to-motor repair): the motor nerve of the gastrocnemius muscle and sural nerve were transected and their distal and proximal ends, respectively, were repaired. At follow-up periods of 6, 12, and 24 weeks, evaluation of hair growth, muscle atrophy, and sensory evoked potentials was performed. Somatosensory evoked potentials (SSEP) at 6 weeks in the sensory-to-motor repair (group III) revealed a significant (P < 0. 05) increase (104.4% +/- 22.9) in the relative response of peak-to-peak potentials when compared with group I (46.6% +/- 19) and group II (51.8% +/- 14.0). Muscle flap stimulation was most prominent at 6 weeks in sensory-to-motor reinvervated flaps (group III 133.1% +/- 25.4; group I 84.9% +/- 20.2). In this study, sensory-to-motor nerve repair significantly improved the sensibility of skin flaps at 6 weeks. Denervated flaps presented with 3 months of sensory recovery delay.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessment of muscle flap sensibility by evoked potentials in the rat

Siemionow

Latıfoǧlu²,

Demirkan³

et al. 2000

Microsurgery

View full text Add to dashboard Cite

show abstract

“…8 Morris et al reported 94% success rate with conventional cross-leg flap, and by incorporating the fascia, the success rate approaches nearly 100%. 9 In our study, we had 100% success of the flaps. All the patients underwent cross leg flap because free flap was not an option because of extensive soft tissue injury with injury to lower limb vasculature.…”

Section: Discussionmentioning

confidence: 80%

Cross leg flaps: are they relevant in the present era?

2017

View full text Add to dashboard Cite

Background: Injuries of lower limb due to road traffic accidents are challenging to reconstruct due to paucity of tissues and damage to vasculature. Recurrent trophic ulcers are also difficult to reconstruct due to stigmata of previous surgeries. When local and regional flaps are not available, free flaps become the best option. The success of free flap depends on the presence of healthy recipient vessels and microsurgical expertise. In cases where the free flaps have failed or when there is no available soft tissue for local flaps, cross leg flaps are a method of resurfacing and salvaging the limb.Methods: This Study was done from January 2013 to January 2016 in Rajiv Gandhi Government General Hospital, Chennai. 20 patients were included in the study and the flaps used were conventional cross leg and cross leg reverse superficial sural artery flap.Results: All flaps survived. There was one case of wound dehiscence managed by re-insetting, two cases with marginal necrosis which were managed conservatively. One case of partial loss which was managed by STSG and one case of sinus formation due to tuberculosis managed with ATT. Remaining flaps had no complications.Conclusions: Cross leg flaps are still relevant in the present era of microsurgery. They can be the primary choice of reconstruction or as a workhorse when free flaps have failed or other loco regional flaps are already exhausted. Immobilisation and two stage reconstruction are few disadvantages which when weighed against limb salvage are acceptable.

show abstract

“…Wells et al reported that Type IIIB tibial fractures carried a significantly higher risk of free-flap failure than the other types of fracture, and stable, long-term coverage of the free flaps was achieved only in 78% of patients [10]. success rate with conventional cross-leg flap, and by incorporating the fascia, the success rate approaches nearly 100% [12]. For free flap, most of the centers reports success rate in the range of 90% -92% [13].…”

Section: Discussionmentioning

confidence: 99%

Cross-Leg Flap: Its Reliability and Outcome

Shoeib¹

2013

MPS

View full text Add to dashboard Cite

Background: Cross-leg flaps for lower limb wound coverage have been replaced by free tissue transfer in the last two decades. However, there are certain difficult situations where the free flap cannot be employed and alternative methods are needed. We describe our experience with cross-leg flap in 135 patients for the reconstruction of difficult leg defects in which no possible other options available for reconstruction of the defect. Materials and Methods: This study was carried upon one hundred thirty five patients suffering from leg and/or foot soft tissue injury. This study focused on the cases that need coverage of bone, tendons, and neurovascular bundle, while those that managed by local flap or split thickness graft were excluded. Results: All patients ambulate well after 5 -10 days, except for 14 patients who had associated orthopedic problems as external fixation, or other fractures. Cosmetic outcome were excellent in all patients, but 3 patient's mothers complaint of bulky flap, and for them liposuction was done with postoperative satisfaction. 2 cases complaint of early donnar sit graft, but later on they were satisfied. Conclusion: Cross-leg flap offers the possibility of salvaging limbs that are otherwise nonreconstructable.

show abstract

The place of the cross-leg flap in reconstructive surgery of the lower leg and foot: A review of 165 cases

Cited by 61 publications

References 8 publications

Assessment of muscle flap sensibility by evoked potentials in the rat

Assessment of muscle flap sensibility by evoked potentials in the rat

Cross leg flaps: are they relevant in the present era?

Cross-Leg Flap: Its Reliability and Outcome

Contact Info

Product

Resources

About