Clinical study of upper one third leg defects

Large soft tissue leg defect involving upper and middle third remains a therapeutic challenge. Clinical study of management of upper one third defects was done to analyze the various reconstructive procedures for leg defects and also to enhance the quality of work done to produce good results with minimal complications as possible. This Prospective Clinical study conducted in the department of Plastic and Reconstructive surgery, includes 20 cases of upper one third of leg defects admitted. Patients >15years of age with Soft-tissue defects of upper one third leg requiring flap cover are included in this study. The operative procedure was chosen according to the nature and size of the defect. The earliest flap cover was given within 1 week of trauma. Primary flap cover was given in 10 (50%)patients, delayed primary flap cover in 9 (45%) patients and secondary flap cover in 1 (5%) patient. In 14 (70%) patients Gastrocnemius flaps were done, of which Gastrocnemius muscle flaps with SSG were done in 9 patients (45%) and Gastrocnemius Myocutaneous flap in 5 patients (25%). Fasciocutaneous Flaps in 4 patients (20%), Venous flap in one patient (5%) and Advancement Flap in 1 patient (5%) were done.