Flap as savior in the extremity injuries

Orthoplastics for the Orthopedic surgeons

1. Flap for Orthopedic Surgeon and Patient: Is it Savior? Suresh Pandey

2. Case 1 Option??? Exposed popliteal artery, vein, tibial and peroneal nerve with degloving with contralateral femur fracture

3. Case 2. 8yrs of non healing venous ulcer with failed SSG. Next plan?

4. Case 3, 4 Option?

5. Case 5, 6. How to proceed?? Pelvis and acetabulum fracture with Morrel Lavale syndr TBI with polytrauma with bed sore

6. Case 7. What is the next step? Open tibia and calcaneum with exposed bone n IMIL in situ

7. Case 8, 9. Management?? NF complication with exposed tendon wrist 13 cm TendoA loss with huge defect with bimalleolar fracture

8. Case 10? Next plan? IIIB open tibia with exposed tibia at fracture site

9. Role of flap To avoid/minimize Bone necrosis Tendon and vessel necrosis Infection OM Non union Wound healing

10. Case 1 Option???

11. Med H Gastroc flap

12. What is Gastroc Flap Indications Proximal 3 rd leg Knee Popliteal fossa

13. Case 2. Next plan?

14. Reverse sural A flap principle Indications Distal 3 rd leg Ankle TA insertion Heel

15. Sural Flap

16. Contd …

17. Case 3 Option?

18. Med H gastroc

19. Case 5 How to proceed??

20. TFL flap

21. Case 6

22. Principle Rotation flap

23. Principle TFL flap Indication Trochanteric area Gluteal defect Anterior prox thigh and groin

24. Case 7. What is the next step?

25. Combined Medial H gastroc plus Sural flap

26. Case 10? Next plan?

27. Medial Hemi Soleus flap

28. Principle of Hemi Soleus Flap

29. Bosworth technique for TA n sural flap for coverage

30. Groin Flap

31. Principle of Groin Flap

32. Take Home Message Knowledge of anatomy and surface marking important Early decision and intervention better Emphasis on meticulous debridement and infection control Address fracture Remember constraint set up Sweat and Toils from your side and patience from patient’s side are keys to success