Use of fasciocutaneous flap for open-type III B tibial fractures--clinical experience and analysis.

Full thickness soft tissue defect over tibia is a big problem. Between December 2004 and July 2006, 20 patients of open Gustilo type IIIB tibial fractures were treated with fasciocutaneous flap after initial external fixation and control of infection done as evidenced by negative culture sensitivity test. The flap was chosen from the area between superior flexion crease of the calf at the popliteal fossa to the junction of the middle and inferior thirds of the posterior calf. The delay in flap surgery was mostly due to associated infection. Good results with satisfactory union were achieved in 85% cases. Infection occurred in 2 cases (10%). Marginal and full thickness necroses in this series were seen with sural flap; 2 cases (10%) developed partial necrosis of flap which was managed by skin graft and 1 (5%) developed full thickness necrosis. Fasciocutaneous flap helps in fracture union, control of infection and improves the functional outcome.