Introduction: This study was done to evaluate the usefulness of V–Y advancement gluteus maximus fasciocutaneous flap in the management of sacral defects. Material and methods: A total of 15 patients with sacral defects either due to sacral pressure sores or defects following excision of sacral soft tissue tumors were treated using this technique in a single stage. The size of the defect and postoperative complications in each patient were assessed. The follow-up period was a minimum of 1 year. Results: All wounds healed with no recurrence. During follow-up, two patients had wound healing problems with wound discharge which healed with dressings within 2 months. Conclusion: The use of V–Y advancement gluteus maximus fasciocutaneous flap offers an easy and safe flap in sacral defect reconstruction.

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Hemangiomas are benign tumors of the vascular endothelium and mucous membranes. Despite their common occurrence, especially during the infantile period, hemangiomas located in the genital region represent one of the rarest sites. Genital hemangiomas are frequently congenital but may emerge later in life. Genital hemangioma involving the entire penis and scrotum are extremely rare. More rarely, they can extend in to the pelvis making preoperative imaging imperative and decisive in treatment. Very few cases have been reported in the medical literature. We are presenting here a case of extensive penile shaft hemangioma in an 8-year-old male child with review of literature.

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Complex lower extremity injuries pose a significant challenge in terms of management especially when the distal leg is involved. This is compounded by the fact that many patients in this environment who sustain fractures present to traditional bone setters before presenting to the hospital often with complications. We present a 26 year old man with severe right leg injury following a road traffic accident who presented to us at Ntasiobi Specialist Hospital, Enugu, Nigeria for amputation through a traditional bonesetter. He had comminuted fractures of the tibia and fibula with periosteal stripping and an extensive soft tissue loss affecting the distal ½ and about ⅔ of the circumference of the right leg. This degree of injury required free flap reconstruction which was not feasible. We used external fixator to stabilize the bones and improvised negative pressure dressing with a delayed distally based posterior calf fasciocutaneous flap for wound cover. The limb was salvaged though with some challenges but patient was satisfied with the outcome.

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Leg ulcer is a common cause of morbidity and source of social and economic distress, especially among the young and middle aged people. It often results from or associated with venous insufficiency, for which a number of theories have been implicated. Limb elevation and compression bandaging have thus become cornerstones in the management of most leg ulcers. We report a case of a 50-year-old man with leg ulcer and a previous history of ipsilateral gastrocnemius flap. We propose the hypothesis of muscle pump failure as a cause of the leg ulcer.

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