Fasciocutaneous cross leg flap combined with stabilization of lower extremities with Ilizarov fixator as a effective salvage procedure for treatment of soft tissue defects with infection and exposure of tibia – case report

Abstract

Chronic active tibia osteomyelitis accompanied by soft tissue defects with exposed bone, infected pseudoarthrosis or pathological fractures are a recon- structive challenge to the orthopedic surgeon. We present a case of a 68 year-old patient with chronic tibia osteomyelitis associated with a wound exposing tibia diaphysis. The successful local debridement and reaming of a tibia followed by local antibiotic delivery and cross-leg flap transfer from opposite tibia with stabilization of lower extremities with Ilizarov fixator was achieved in two stages. After 14 months the patient is free from infection and skin defect, able walk with full weight bearing. We consider securing of cross-leg flap with stabilization of lower extremities with Ilizarov fixator as relevant for successful reconstructive procedure for soft tissue defect over tibia in cases of osteomyelitis not suitable for local or microsurgical flap.