The role of early flap coverage in the management of open fractures of both bones of the leg.

Sixty patients with type III injuries (open fractures) of the tibia were treated in a prospective fashion by combined orthopaedic and plastic surgical schemes based on the principles of early radical cleaning, a second-look operation, and early coverage of soft tissue defects with an appropriate local or distant flap. Stabilization of fractures was achieved by external fixation in most cases and patients were allowed to walk within 4-8 weeks (partial weight bearing). Bony union was achieved in 23.4 weeks. The mean hospital stay was 3.5 weeks. Limb salvage was achieved in all cases and there were no major complications.