Arch Plast Surg.  2021 Nov;48(6):699-702. 10.5999/aps.2021.01186.

Long-term follow-up of a severely traumatized leg treated with ipsilateral fracture-united fibular transfer in a patient with amputation of the contralateral leg: a case report

• Kim ES
• Yang CE
• Kim J
• Kim SW

• KMID: 2522420
• DOI: http://doi.org/10.5999/aps.2021.01186

Abstract

Extensive bone loss associated with severe vascular injury remains a challenge for lower extremity reconstruction. The fibular free flap has been utilized for many decades to reconstruct long-segment tibial defects. We present an unusual scenario of unilateral weight-bearing, wherein we salvaged the sole lower extremity by transfer of the fractured ipsilateral fibula and a bipedicled skin flap. A 38-year-old man sustained a severe crush injury in the right leg with loss of circulation. His left lower leg had a soft tissue defect measuring 20×15 cm with an exposed comminuted fracture and a 17-cm tibial defect, along with a segmental fracture of the fibula. Subsequently, we reconstructed the tibial defect by transferring a 17-cm-long section of the ipsilateral fibula. We covered the soft tissue defect with a bipedicled skin flap. The patient eventually began to ambulate independently after surgery.

Keyword

Fibula / Lower extremity / Pedicled flaps / Tibial defect