Untitled

Abstract

Pedicled cross-extremity flaps for wound coverage have been replaced, in most cases, by free tissue transfer. Classically, cross-leg flaps have been problematic because of difficulties with immobilization and positioning of the extremities from the time of initial coverage to detachment. Three children with severe foot and ankle trauma had cross-extremity flaps using linkage of bilateral lower-extremity external fixators in place of traditional casting. Cross-leg flaps were used in two patients, and a cross-foot flap was applied in one. Each flap survived completely, and the linking fixators were disassembled at the time of flap detachment. No complications were related to the donor site or the flap itself or were caused by the fixation. Lower-extremity range of motion was regained rapidly, and each patient resumed essentially normal gait and activity. Addition of external-fixator stabilization aids greatly in wound care, as well as general ease of patient mobility and positioning. External fixation facilitates the use of cross-extremity flaps in pediatric patients in whom free tissue transfer may not be optimal.

Non-microsurgical skin flaps for reconstruction of difficult wounds in distal leg and foot

“…The appearance of skin graft alone on the donor site was better than the mosaic appearance of the residual part of the flap and the skin graft. 25 …”