Reconstruction of lower limb traumatic soft tissue defects in Togo

Abstract

Background: The management of lower limb soft tissue defects is still a challenge in our setting. Aims: This study aimed to review the clinical and socio-demographic characteristics of the patients with traumatic lower limbs defect and evaluate the results of surgical management in our setting. Settings and Design: Retrospective descriptive study. Materials and Methods: The charts of 30 adults patients treated surgically for lower limb soft tissue defects in the period from 1 January to 31 December 2014 were reviewed. Socio-demographic, clinical and therapeutic characteristics were documented. Statistical Analysis Used: The results were as general descriptive statistics, presented as medians, percentages and ranges. Results: The mean age was 34 years (range 18–60 years). The sex ratio was 3.28 for men. In 83% of the cases (20/30), injuries were due to collision between motorcycle and other vehicles. Soft tissue defects were type III B (50%, 15/30) and III A (47%, 14/30) of Gustilo-Anderson classification. The mean time between injury and reconstructive surgery was 48 days (range 14–118 days). Reconstruction techniques were mostly split skin graft (53%, 16/30) and neuro-sural distal pedicled flaps (20%, 6/30). Five cases of persistent osteomyelitis were observed. Conclusion: The non-availability of microsurgery limited our practice to regional and local flaps that gave good results and protected bone fractures that mainly healed in acceptable time.