Fatih Ilker Can, Burak Şener

Department of Orthopedics and Traumatology, Muğla Training and Research Hospital, Muğla, Türkiye

Keywords: Cross-leg flap, lower extremity defects, microsurgery, soft tissue defect, soft tissue reconstruction.


Objectives: This study aimed to present our experiences with cross-leg flap surgery, which demonstrates successful outcomes in lower limb soft tissue defects without the necessity of microsurgical intervention.

Patients and methods: The retrospective study included 26 patients (18 males, 8 females; mean age: 35.6±12.2 years; range, 18 to 65 years) between January 2015 and September 2019. A fasciocutaneous cross-leg flap was applied to the recipient extremity, and the extremities were immobilized by a tubular external fixator. Flap divisions were performed on the 21st postoperative day. At least two years of clinical outcomes were presented.

Results: Twenty-five flaps survived and recovered completely without any complication at the donor site, flaps, or the recipient area. In one diabetic patient, partial flap loss was encountered, which granulated with secondary healing. All patients demonstrated stable wound coverage, with none demanding additional soft tissue surgeries. All patients resumed normal ambulation and physical activity without any residual joint stiffness.

Conclusion: Cross-leg flap method is an effective and respectable option for extremity salvage as a good alternative to free flaps for the management of traumatic complex lower limb defects. This method is simple, provides abundant blood supply to the wound, and does not require microsurgical experience or a good working recipient artery.

Citation: Can FI, Şener B. Cross-leg flaps: A nonmicrosurgical alternative treatment method in complex lower extremity trauma reconstruction. Jt Dis Relat Surg 2024;35(2):347-353. doi: 10.52312/ jdrs.2024.1562.

Ethics Committee Approval

The study protocol was approved by the Izmir Bakırçay University Non-invasive Clinical Research Ethics Committee (date: 17.01.2024, no: 1426). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Design, data collection and processing, analysis and interpretation, writing the article, references and fundings: F.İ.C.; Idea/concept, control/ supervision, literature review, critical review, materials: B.Ş.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.