Mohammed Zafar Iqbal, Mohammed Razzaq Malik, Mohammed Azeem, Irfan Mehboob.
Soft tissue defects in open tibial fractures and their management by fasciocutaneous flaps.
J Sheikh Zayed Med Coll Jan ;1(3):98-101.

Background: Most of the traumatic injuries to the tibia are caused by motor cycle or automobile accidents. Motor cycle related tibial injuries have high incidence of skin and soft tissues loss. To decrease the ensuing burden, a spectrum of activities is needed, including injury surveillance, injury prevention and improvement in care of the wound e.g. by use of fasciocutaneous flaps. Objective: To determine the efficacy of using fasciocutaneous flaps in covering soft tissue defects in open tibial fractures. Patients and Methods: This study was a descriptive study, conducted in the orthopaedic unit of Sheikh Zayed Medical College, Rahim Yar Khan, from July 2008 to June 2009. All those patients who had skin loss over the tibia with intact distal neurovascular status along with ample normal surrounding skin were included in the study. Data was collected regarding age, sex of patients, size of the wound, site of the wound, level of fracture, mode of injury and use of any preventive/ protective measures. Results: Twenty cases had open tibial fractures that needed fasciocutaneous flaps; there were 19 (95%) males and one (5%) female. Twelve (60%) flaps were proximally based, two (10%) transversally based and six (30%) distally based. Eleven (55%) flaps were between 6cm to 8cm. All (20) the flaps survived (100%). Complications were noted in 9 (45%) patients. Majority (95%) did not use any protective/ preventive measures for accidents. Conclusion: This study concluded the worthwhile efficacy of the fasciocutaneous flaps. The incidence of the injury can be reduced by observing traffic rules and improving road safety.

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