LOCAL-ADVANCEMENT SOFT-TISSUE COVERAGE IN A CHILD WITH IPSILATERAL GRADE IIIB OPEN TIBIAL AND ANKLE FRACTURES

This case describes the successful treatment of a child with a vascula r injury and two ipsilateral grade IIIB open lower leg fractures using two local-advancement soft-tissue techniques. Multiple relaxing skin incisions were used for closure of the wound associated with the patie nt's midshaft tibial fracture, whereas a randomly patterned rotational fasciocutaneous flap was used for coverage of the wound associated wi th the patient's medial malleolar fracture. These straightforward loca l-advancement soft-tissue coverage techniques allowed for treatment of a child with vascular injuries, ensuring the viability of the foot, w hile preventing distant donor site morbidity and functional sacrifice. Additionally, no special microsurgical or specialty training is neces sary to achieve a similar result.