2010 Volume 1 Issue 2 Pages 74-80
We investigated outcomes of early reconstruction for open fracture of upper and lower extremities. From January 2000 through December 2007, we performed early reconstruction for open fractures to upper and lower extremities using 24 free flaps including 14 cases with anterolateral fasciocutaneous flap, 6 cases with latissimus dorsi myocutaneous flap, and 4 cases with rectus abdominis myocutaneous flap. Even though complications occurred, including congestion in 2 cases and partial necrosis in 1 case, all flaps survived. Deep infection occurred in 2 cases: 1 case was stable with only debridement, and the other case was a Gustilo type IIIC open tibial fracture with the application of a rectus abdominis myocutaneous flap. An infection subsequently occurred at the calcaneus and eventually required a below-knee amputation. Early reconstruction for open fracture using a well-vascularized free flap reduces the complication of postoperative osteomyelitis and necessity for amputation. Therefore, it is important for plastic surgeons to recognize the need for reconstruction of complex soft tissue defects and treat them in cases of severe open fractures of the upper and lower extremities immediately after injury.
