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Abstract
The lower extremities of the human body are more commonly known as the human legs, incorporating: the foot, the lower or anatomical leg, the thigh and the hip or gluteal region.The human lower limb plays a simpler role than that of the upper limb. Whereas the arm allows interaction of the surrounding environment, the legs’ primary goals are support and to allow upright ambulation. Essentially, this means that reconstruction of the leg is less complex than that required in restoring functionality of the upper limb. In terms of reconstruction, the primary goals are based on the preservation of life and limb, and the restoration of form and function. This paper aims to review current and past thoughts on reconstruction of the lower limb, discussing in particular the options in terms of soft tissue coverage.This paper does not aim to review the emergency management of open fractures, or the therapy alternatives to chronic wounds or malignancies of the lower limb, but purely assess the requirements that should be reviewed on reconstructing a defect of the lower limb.A summary of flap options are considered, with literature support, in regard to donor and recipient region, particularly as flap coverage is regarded as the cornerstone of soft tissue coverage of the lower limb.
Highlights
This paper does not aim to review the emergency management of open fractures, or the therapy alternatives to chronic wounds or malignancies of the lower limb, but purely assess the requirements that should be reviewed on reconstructing a defect of the lower limb
Today’s goal in lower limb reconstruction has not changed much from those originally cited in the early war victims, with restoration, or maintenance of function becoming the essential goal as these injuries became less life threatening
This has been documented for its use in wound coverage until definitive therapy is decided or indicated [5], as well as helping to reduce the size of wound, allowing free flap reconstruction of the massive lower limb wound [96, 97], or the passage down the reconstructive ladder to the point of foregoing the need of even a local flap, something improving investigations and surgical technique is allowing [98]
Summary
The leg consists of four main regions before attaching to the pelvis Working proximally, these are: the foot, the lower or anatomical leg (from the ankle to knee), the thigh (knee to hip) and the hip or gluteal region. Evolution has forced the lower limb to gain this distinct feature, and bipedal gait is not unique to humans, an efficient upright locomotion for long durations is. This adaptation has forced the human leg to become longer and more powerful in comparison with our primate relations, as well as change the way in which the muscles and joints of the leg interact and function [1]. The ability of the legs to offer support and allow upright ambulation has permitted the adaptation of the upper limb, the arm, to allow precise interaction with the surrounding environment
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