Abstract
Management of composite defects of leg following trauma requires a planned ortho-plastic
approach right from the outset. Timely, planned intervention results in reduced amputation
rates and improved limb salvage and function. Right from the time of presentation
of the patient to the emergency with such injury, the process of decision making in
terms of salvage or amputation, local flap cover/free flap cover, bone reconstruction
first or soft tissue or both combined, come into play. Guidelines on management are
unclear for such defects, a literature search yielding various methods being used
by different authors.
This article is a review of current literature on management of composite leg defects.
A summary of the literature search in terms of various management options given by
various authors including the rationale, advantages and disadvantages of each strategy
has been provided in this article. The management protocol and method followed by
the author in his institute for management of such composite defects have been described
in detail. The article seeks to provide readers with an understanding of the management
strategies so that appropriate method could be chosen to provide best result.
Keywords
bone defect - composite defect - leg trauma - lower limb trauma - free fibula - free
flap - distraction - Ilizarov
