Use of Propeller Flap in the Coverage of Soft-Tissue Injury in the Lower Limb

A retrospective study, with review of medical records, and a convenience sample of 14 patients operated between July 2018 and June 2019. The following clinical aspects were evaluated: sex; age group; type of injury; cause of the injury; initial diagnosis; affected location; techniques for incision and identification; surgical planning; flap design; postoperative period; result of the propeller flap; and complications.

Results

The sample was composed of male patients (100%), with a mean age of 36.4 years, and 92.7% of the injuries resulted from motorcycle accidents, mostly on the right side (71.4%). The surgical planning of the propeller flap followed the same procedure in all cases. Immediate postsurgical complications were present in 35.7% of the cases, and they included excessive bleeding (14.3%), partial necrosis (14.3%), and flap dehiscence (7.1%). In total, 13 patients had excellent coverage, and only 1 had flap loss.

Conclusion

The propeller-flap technique to cover lesions in the lower limb proved to be a good alternative in most cases evaluated, with a good surgical result, although complications were observed in some cases.

Keywords
soft tissue injuries; perforator flap; lower extremity

Case	Age (years)	Flap (cm)	Affected location	Complications	Additional procedures
1	42	10 × 2	Medial face of the distal third of the right leg	No Complications	Skin graft
2	37	7 × 7	Medial face of the distal third of the left leg	Bleeding	Flap slimming
3	48	10 × 7	Distal posterior face of the right leg	No Complications	Skin graft
4	46	8 × 3	Posterior face of the distal third of the left leg	Bleeding	None
5	48	11 × 4	Distal posterior face of the right leg	No Complications	Skin graft
6	48	7 × 5	Medial face of the distal third of the right leg	No Complications	None
7	35	9 × 4	Medial face of the distal third of the right leg	No Complications	None
8	35	5 × 3	Medial face of the middle third of the right leg	No Complications	None
9	26	6 × 4	Distal posterior face of the right leg	Partial flap necrosis	Skin graft
10	28	5 × 3	Distal posterior face of the right leg	Flap dehiscence	None
11	27	4 × 3	Medial face of the middle third of the right leg	No Complications	None
12	32	6 × 4	Lateral face of the distal third of the left leg	Partial flap necrosis	None
13	27	6 × 4	Lateral face of the distal third of the right leg	No Complications	Skin graft
14	31	8 × 3	Medial distal third of the left leg	No Complications	Skin graft

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Ricardo Gouvea Goulart, Departmento de Ortopedia e Traumatologia, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Av. Pedro Ludovico, Goiânia, GO, 74820-300, Brazil (e-mail: ricardoggoulart@gmail.com).

Brasil

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Use of Propeller Flap in the Coverage of Soft-Tissue Injury in the Lower Limb* * Work developed at the Department of Orthopedics and Traumatology, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brazil.

Abstract

Objective

Materials and Methods

Results

Conclusion

Use of Propeller Flap in the Coverage of Soft-Tissue Injury in the Lower Limb^* * Work developed at the Department of Orthopedics and Traumatology, Hospital de Urgências de Goiânia Dr. Valdemiro Cruz, Goiânia, GO, Brazil.