Mehvish Murtaza, Yawar Sajjad, Muhammad Aamer Aslam.
Comparison of Outcome in Coverage of Open Fractures of Tibia with Pedicled Fasciocutaneous Flaps and Muscle Flaps with Overlying Graft in patients Presenting to Plastic Surgery Department, Lahore General Hospital, Lahore.
Pak J Med Health Sci Jan ;13(1):153-6.

Background: Open fractures of tibia are high energy injuries which are normally treated by internal fixation, debridement and wound closure. These are often complicated by deep infection and pose a reconstructive challenge to orthopedic surgeons. Prognosis largely depends on initial bone displacement, soft-tissue injury, type of flap used and skills of the treating surgeon. Aim: To compare of outcome in coverage of open fractures of tibia with pedicled fasciocutaneous flaps and muscle flaps with overlying graft. Methods: This is a cross-sectional comparative study conducted at Lahore General Hospital, Lahore, Pakistan from January 2011 to January 2018. All the patients of Gustilo Anderson type IIIb, treated with flap repair by the author during this time period were included in this study. Proximal defects were covered with gastrocnemius muscle flap while middle and distal wounds of tibia were covered using soleus muscle flap. Results: Middle 1/3 of the tibia is the most common fracture site (n=14, 60.9%), followed by proximal 1/3 (n=7, 30.4%) and distal 1/3 (n=2, 8.7%). Significant correlations (.773, p-value <0.001) exist between flap size andlength of hospital stay when adjusted for age of the patients. Conclusion: Pedicled fasciocutaneous flaps and muscle flaps with overlying graft are equally effective in the management of open tibial fractures.

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