Background: Cross-leg flaps for lower limb wound coverage have been replaced by free tissue transfer in the last two decades. However, there are certain difficult situations where the free flap cannot be employed and alternative methods are needed. We describe our experience with cross-leg flap in 135 patients for the reconstruction of difficult leg defects in which no possible other options available for reconstruction of the defect. Materials and Methods: This study was carried upon one hundred thirty five patients suffering from leg and-or foot soft tissue injury. This study focused on the cases that need coverage of bone, tendons, and neurovascular bundle, while those that managed by local flap or split thickness graft were excluded. Results: All patients ambulate well after 5 - 10 days, except for 14 patients who had associated orthopedic problems as external fixation, or other fractures. Cosmetic outcome were excellent in all patients, but 3 patient’s mothers complaint of bulky flap, and for them liposuction was done with postoperative satisfaction. 2 cases complaint of early donnar sit graft, but later on they were satisfied. Conclusion: Cross-leg flap offers the possibil- ity of salvaging limbs that are otherwise nonreconstructable.
Cite this paper
M. A. Shoeib, "Cross-Leg Flap: Its Reliability and Outcome," Modern Plastic Surgery, Vol. 3 No. 1, 2013, pp. 9-14. doi: 10.4236/mps.2013.31003.
 G. I. Taylor, P. Townsend and R. Corlett, “Superiority of the Deep Circumflex Iliac Vessels as the Supply for Free Groin Flaps: Clinical Work,” Plastic and Reconstructive Surgery, 1979, Vol. 64, No. 6, pp. 745-759.
 M. Topalan, “A New and Safer Anastomosis Technique in Cross-Leg Flap Procedure Using the Dorsalis Pedis Arterial System,” Plastic and Reconstructive Surgery, Vol. 105, No. 2, 2000, pp. 710-713.
 B. J. Kamath, T. Varghese and P. Bhard, “A Modified Cross Leg Flap for Large Triangular Defects of the Foot and Ankle,” The Foot & Ankle Journal, Vol. 1, No. 8, 2008, pp. 21-24.
 B. Ponten, “The Fasciocutaneous Flap. Its Use in Soft Tissue Defects of Lower Leg,” British Journal of Plastic Surgery, Vol. 34, No. 2, 1981, pp. 215-220.
 R. B. Stark, “The Cross Leg Flap Procedure,” Plastic and Reconstructive Surgery, Vol. 9, No. 3, 1952, pp. 173-204.
 S. Devansh, “Prefabricated Recipient Vascular Pedicle for Free Composite-Tissue Transfer in the Chronic Stage of Severe Leg Trauma,” Plastic and Reconstructive Surgery, Vol. 96, No. 2, 1995, pp. 392-399.
 A. Yamada, K. Harii, K. Ueda, H. Asota and H. Tanaka, “Versatility of a Cross Leg Free Rectus Abdominis Flap for Leg Reconstruction under Difficult and Unfavorable Conditions,” Plastic and Reconstructive Surgery, Vol. 95, No. 7, 1995, pp. 1253-1257.
 C. S. Lai, S. D. Lin, C. K. Chou and Y. M. Cheng, “Use of a Cross-Leg Free Muscle Flap to Reconstruct an Extensive Burn Wound Involving a Lower Extremity,” Burns, Vol. 17, No. 6, 1991, pp. 510-513.
 H. Chen, T. A. El-Gammal, F. Wei, H. Chen, M. S. Noordhoff and Y. Tang, “Cross-Leg Free Flaps for Difficult Cases of Leg Defects: Indications, Pitfalls, and Long-Term Results,” Trauma, Vol. 43, No. 3, 1997, pp. 486-491.
 M. D. Wells, C. V. Bowen, R. T. Manktelow, J. Graham and J. B. Boyd, “Lower Extremity Free Flaps: A Review,” Canadian Journal of Surgery, Vol. 39, No. 3, 1996, pp. 233-239.
 D. Serafin, N. Georgiade and D. H. Smith, “Comparison of Free Flaps with Pedicled Flaps for Coverage of Defects of the Leg or Foot,” Plastic and Reconstructive Surgery, Vol. 59, No. 4, 1977, pp. 492-499.
 A. M. Morris and A. C. Buchan, “The Place of the Cross-Leg Flap in Reconstructive Surgery of the Lower Leg and Foot: A Review of 165 Cases,” British Journal of Plastic Surgery, Vol. 31, No. 2, 1978, pp. 138-142.
 G. G. Hallock, “Impact of the Successful Flap but Failed Reconstruction on the True Rate of Success in Free-Tissue Transfers,” Journal of Reconstructive Microsurgery, Vol. 16, No. 8, 2000, pp. 589-592.
 D. J. Hodgkinson and G. B. Irons, “Newer Applications of the Cross-Leg Flap,” Annals of Plastic Surgery, Vol. 4, No. 5, 1980, pp. 381-390.
 A. P. Landra, “Salvage of a Seriously Injured Lower Limb with a Musculo-Cutaneous Cross-Leg Flap,” British Journal of Plastic Surgery, Vol. 35, No. 1, 1982, pp. 40-42. doi:10.1016/0007-1226(82)90081-9
 D. A. Hudson and K. Millar, “The Cross-Leg Flap: Still a Useful Flap in Children,” British Journal of Plastic Surgery, Vol. 45, No. 2, 1992, pp. 146-149.
 C. D. Long, M. S. Granick and M. P. Solomon, “The Cross-Leg Flap Revisited,” Annals of Plastic Surgery, Vol. 30, No. 6, 1993, pp. 560-563.