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Rotación de colgajos musculares para cobertura de defectos en fracturas abiertas de tibia producidas por armas de fuego

Keywords: firearms open fractures, leg, muscular flaps, soleus, gastrocnemius.

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Abstract:

introduction: tibial open fractures caused by firearms are lesions requiring a radical and appropriate debridement. fracture stabilization and early cover of soft parts with well visualized tissue. rotator muscular flaps of soleus and gastrocnemius muscles play a significant role in cover of such lesions. the aim of present paper was to show the results of cover of this type of legs fractures using muscular flaps from gastrocnemius and the soleus muscles. methods: present series includes 25 patients with open tibial fractures caused by firearms, 8 of them were of type iii a and 17 of type iii b. lesions were located in high third of the tibia (6), in medium third (15) and in lower medium third (4). the muscles used for flaps were the gastrocnemius medial head (19 patients) and the medium part of soleus (6 patients). results: average time for flap placement after lesion was of 12 days. among complications present there was a partial flap necrosis (1 patient) and the superficial infection (2 patients) resolved with medical treatment. conclusions: rotator muscular flaps are an essential alternative of treatment in open fractures caused by firearms and may be placed by an orthopedic surgeon without microsurgical techniques. thus, it is possible the cover of a simple structures with a low rate of complication.

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