Following an open lower limb fracture (broken bone and overlying skin damage) it may not be possible to fix the bone and close the overlying skin. In these situations we often work jointly with the orthopaedic surgeons to provide skin cover. This is normally done in an emergency setting immediately after the injury. Skin and fat can be taken from your thigh, your forearm, your tummy or your back and then transplanted to cover broken bone in your leg. These types of reconstruction are tailored for your specific injury and usually involve some form of microsurgery, so combined with the fracture fixation they can often take all day. The recovery period can often take months and involve intensive rehabilitation. This type of reconstruction can also in some situations be done later on if there have been problems with skin healing over a broken bone.
Normally there are not many options following high energy lower limb trauma when bones and skin are injured. You do however need to be fit enough for a general anaesthetic and prepared for intensive post-operative rehabilitation.
An assessment over the leg needs to be made to ensure that it will be viable following the reconstruction. Sometimes in severe limb injuries amputation may be a better and faster recovery. There are risks that this type of reconstruction may fail in the short term as well as the risk of scars, revisional surgery and bone infection in the long term.
Reconstructing alert after major trauma. Risks include failure, infection, scars, bone healing problems. At least a week stay in hospital with recovery taking 6-18 months