Objective To discuss the effects, indications and methods of π-shaped locking com-pression plates plus open reduction for Barton fractures. Methods From January 2006 to January 2007, 21 cases of Barton fractures were treated by open reduction from dorsal incision and fixation by π-shaped locking compression plates. Of them, 14 also had bone grafting and 6 had protection by a plaster brace. Results Follow-ups for 6 to 18 (average, 10) months showed all the patients got bone union. The differences between preoperative and postoperative measurements in palmar inclination, ulnar deviation and relative length of distal radius were statistically significant (P < 0.05). At the last follow-up, the affected wrist showed no significant difference from the opposite side in dorsal extension, palmar flexion and ulnar deviation (P > 0.05) except in ulnar deviation (P < 0.05). According to the improved Gartland and Werkey grading system, the wrist function was evaluated as excellent in 15 eases, good in 4, and fair in 2. The good to excellent rate was 90. 5%. Conclusion Open reduction from dorsal incision and fixation by π-shaped locking compression plate is an effective treatment for Barton fractures.

Objective To report the technique and effect of distally based, cross-leg, anterolateral thigh flap for reconstructing the soft tissue defects in middle and distal thirds of the contralateral leg. Methods Five patients of soft tissue defects in lower legs associated with injuries to the eontralateral legs were treated with distally based, cross-leg, anterolateral thigh flaps of the contralateral limbs. Results After the pedicle division at 6 weeks postoperatively, the 5 flaps all survived. And the blood supply of flaps remained steady when followed up for 12 to 15 months. The flaps possessed favorable contours, and allowed successful secondary repair of injured bones or tendons. The donor sites healed primarily, and no influence was observed to the donor limbs. Conclusion For the soft tissue defects in middle and distal thirds of leg associated with damage to the surrounding tissues and arterial injury of the contralateral leg, cross-leg transplantation of the contralateral distally based anterolateral thigh flap is a good option of reconstruction.