Annals of Plastic Surgery · 1987 · 30 citations · 0 references
MedicineOrthopaedic SurgerySurgeryMicrovascular ReconstructionReconstructive SurgeryVascular SurgeryFlap ReconstructionFlap SurgeryFree Flap ReconstructionLimb ReconstructionLower Extremity ReconstructionMicrovascular AnastomosisDeep Circumflex Iliac Artery FlapFlap Vascular AnastomosisFlap Vessel AnastomosisFlapsMicrovascular Flap ReconstructionSurgical Technique SelectionVascularized Bone FlapsVascularized Free Flap Reconstruction
Compound fractures of the lower limb with skin and bone loss are difficult repair problems, especially in multiple level injuries. With bone loss between 6 and 12 cms, the deep circumflex iliac artery (DCIA) flap is usually the flap of choice in reconstruction; the aim is to carry out microvascular anastomosis of the flap vessels to vessels on the damaged leg. However, this may be difficult or even impossible. Experience of 10 cross-leg DCIA flaps is outlined, with indications and surgical technique. The long-term bone healing is compared with 13 cases with anastomosis based on the same leg. There appears to be no difference in callus formation and remodelling of bone, indicating that despite subsequently dividing the original main vascular supply the bone in the DCIA flap remains vascularized and behaves as such.