Reconstruction of the Lower Extremity Using Free Flaps
A 41-year-old man underwent open reduction and internal fixation at the department of orthopedic surgery at our medical institution to treat an open fracture of the left tibia received in a traffic accident. Afterwards, however, the patient presented with necrosis of the soft tissue over the pretibial area, accompanied by the presence of a 35 cm × 17 cm soft tissue defect. The patient was therefore referred to us for further evaluation and treatment. We performed debridement in the operation room and prepared the recipient sites. Then, we elevated the left latissimus dorsi muscle free flap and inset it to the recipient site. The artery was anastomosed end-to-end to the anterior tibial artery. In addition, 2 venae comitantes were anastomosed end-to-end, one each to the great saphenous vein and the vena comitante of the anterior tibial artery. A split-thickness skin graft was performed over the flap. Primary closure was performed in the donor site ().