Microsurgical Reconstruction in Traumatic Lower Limb Defects: A Retrospective Analysis of Flap Outcomes and Complications

Abstract

Introduction

Traumatic lower limb defects often involve complex soft tissue defects with vascular injury, exposed bone or tendon necessitating the microsurgical free flap reconstruction. This study aimed to evaluate outcomes and complications of microsurgical free flap reconstruction in traumatic lower limb defects at a tertiary care center.

Methods

This single-centered retrospective analysis included eighteen patients who underwent microsurgical free flap reconstruction for traumatic lower limb defects. Patients with non-traumatic defects were excluded and data were retrieved from medical records and operative notes. Demographics details, injury characteristics, defect location, flap type, postoperative complications, flap survival and time required for complete healing were reviewed.

Results

Among eighteen patients, thirteen were males and five were females with mean age of 33.8 years. The lower third of the leg and foot were the most commonly involved sites of injury. The reconstructive procedures included twelve LD free flap, four gracilis free flap and two anterolateral free flaps. Complete flap survival was achieved in fifteen cases, yielding a survival rate of 83.3%. Three patients required re-exploration due to vascular compromise. Post-operative hospital stay ranged from 15-41 days. Limb salvage was achieved in majority of patients with viable flap coverage.

Conclusion

Microsurgical free flap reconstruction represents an effective and reliable modality for complex traumatic lower limb defects in a resource-limited tertiary care setting. Our flap survival rate of 83.3% and limb salvage rate of 94.4% are comparable to published series from higher-volume centers.