ABSTRACT
Reconstructing a mangled extremity requires careful, complete examination of the functional
and structural status of the injured part. Although the vascular status of the injured
extremity is a priority, simultaneous reconstruction of skeletal, vascular, and neuromuscular
structures should be considered in a combined approach. The purpose of this study
was to describe a one-stage reconstruction of both soft-tissue coverage and revascularization
for a lower extremity, along with functional restoration of an anterior lower leg.
For this purpose, the functioning transfer of a free latissimus dorsi musculocutaneous
flap as a flow-through type was performed. The results demonstrate that the technique
is extremely useful in limb-salvage procedures from both functional and structural
viewpoints.
KEYWORDS
Lower-extremity reconstruction - flow-through latissimus dorsi flap - functional transfer
REFERENCES
- 1
Byrd H S, Spicer T E, Cierney G.
Management of open tibial fractures.
Plast Reconstr Surg.
1985;
76
719-730
- 2
Godina M.
Early microsurgical reconstruction of complex trauma of the extremities.
Plast Reconstr Surg.
1986;
78
285-292
- 3
Dao Q S, Zhang Y F, Yang Q M, Guo B F.
Free gracilis transfer in the treatment of gluteus medius paralysis after poliomyelitis.
J Reconstr Microsurg.
1985;
1
241-244
- 4
Kobayashi S, Sekiguchi J, Sakai Y, Ohmori K.
Functioning free muscle transplantation to the lower leg.
J Reconstr Microsurg.
1995;
11
319-325
- 5
Doi K, Sakai K, Ihara K et al..
Reinnervated free muscle transplantation for extremity reconstruction.
Plast Reconstr Surg.
1993;
92
872-883
- 6
Ihara K, Shigetomi M, Kawai S et al..
Functioning muscle transplantation after wide excision of sarcomas in the extremity.
Clin Orthop.
1999;
358
140-148
- 7
Ihara K, Kishimoto T, Kawai S, Doi K.
Reconstruction of hip abduction using free muscle transplantation: a case report and
description of the technique.
Ann Plast Surg.
2000;
45
177-180
- 8
Willcox T M, Smith A A, Beauchamp C, Meland N B.
Functional free latissimus dorsi muscle flap to the proximal lower extremity.
Clin Orthop.
2003;
410
285-288
- 9
Soutar D S, Scheker L R, Tanner N S, McGregor I A.
The radial forearm flap: a versatile method for intra-oral reconstruction.
Br J Plast Surg.
1983;
36
1-8
- 10
Lamberty B G, Cormack G C.
The antecubital fascio-cutaneous flap.
Br J Plast Surg.
1983;
36
428-433
- 11
Foucher G, van Genechten F, Merle N, Michon J.
A compound radial artery forearm flap in hand surgery: an original modification of
the Chinese flap.
Br J Plast Surg.
1984;
37
139-148
- 12
Costa H, Guimaraes I, Gardoso A et al..
One stage coverage and revascularization of traumatized limbs by a flow-through radial
mid-forearm free flap.
Br J Plast Surg.
1991;
44
533-537
- 13
Lovie M J, Duncan G, Glasson D W.
The ulnar artery forearm free flap.
Br J Plast Surg.
1984;
37
486-492
- 14
Song R, Song Y, Yu Y et al..
The upper arm free flap.
Clin Plast Surg.
1982;
9
27-35
- 15
Masquelet A C, Romana M C.
The medialis pedis flap: a new fasciocutaneous flap.
Plast Reconstr Surg.
1990;
85
765-772
- 16
Naotaka I, Takaya H, Sadao T.
The use of a free medialis pedis flap for resurfacing skin defects of the hand and
digits: results in five cases.
Plast Reconstr Surg.
1995;
95
100-107
- 17
Koshima I, Moriguchi T, Soeda S et al..
Free thin paraumbilical perforator-based flaps.
Ann Plast Surg.
1992;
29
12-17
- 18
Allen R J, Treece P.
Deep inferior epigastric perforator flap for breast reconstruction.
Ann Plast Surg.
1994;
32
32-38
- 19
Brandt K, Khouri R K, Upton J.
Free flaps as flow-through vascular conduits for simultaneous coverage and revascularization
of the hand and digit.
Plast Reconstr Surg.
1996;
98
321-327
- 20
Koshima I, Inagawa K, Sahara K et al..
Flow through vascular toe-joint transfer for reconstruction of segmental loss of an
amputated finger.
J Reconstr Microsurg.
1998;
14
453-457
- 21
Shibata M, Ogishyo N.
Free flaps based on the anterior interosseous artery.
Plast Reconstr Surg.
1996;
97
746-755
- 22
Koshima I, Kawada S, Etoh H et al..
Flow-through anterior thigh flaps for one stage reconstruction of soft-tissue defects
and revascularization of ischemic extremities.
Plast Reconstr Surg.
1995;
95
252-260
- 23
Koshima I, Saisho H, Kawada S et al..
Flow-through thin latissimus dorsi perforator flap for repair of soft-tissue defects
in the legs.
Plast Reconstr Surg.
1999;
103
1483-1490
- 24
Tseng W S, Chen H C, Hung J et al..
Flow-through type free flap for revascularization and simultaneous coverage of a nearly
complete amputation of the foot: case report and literature review.
J Trauma.
2000;
48
773-776
- 25
Nişanci M, Işik S, Duman H.
Flow-through use of the osteomusculocutaneous free fibular flap.
Ann Plast Surg.
2002;
48
435-438
- 26
Chun J K, Marin M L.
Radial artery flow-through flap for distal lower extremity arterial bypass for limb
salvage.
Plast Reconstr Surg.
2003;
111
361-365
- 27
Tamai S, Komatsu S, Sakamoto H et al..
Free muscle transplants in dogs, with microsurgical neurovascular anastomoses.
Plast Reconstr Surg.
1970;
46
219-225
- 28
Manktelow R T, Zuker R M.
The principles of functioning muscle transplantation: applications to the arm.
Ann Plast Surg.
1989;
22
275-282
- 29
Manktelow R T.
Functioning microsurgical muscle transfer.
Hand Clin.
1988;
4
289-296
- 30
Harii K, Ohmori K, Torii S.
Free gracilis muscle transplantation with neurovascular anastomoses for the treatment
of facial paralysis: a preliminary report.
Plast Reconstr Surg.
1976;
57
133-143
- 31
Harii K.
Microneurovascular free muscle transplantation for reanimation of facial paralysis.
Clin Plast Surg.
1979;
6
361-375
- 32
Koshima I, Higaki H, Soeda S.
Combined vascularized fibula and peroneal composite-flap transfer for severe heat-press
injury of the forearm.
Plast Reconstr Surg.
1991;
88
338-341
- 33
Kim D H, Glazer P A.
Progression of idiopathic thoracolumbar scoliosis after breast reconstruction with
a latissimus dorsi flap: a case report.
Spine.
2000;
25
622-625
- 34
Tobin G R, Moberg A W, DuBou R H et al..
The split latissimus dorsi myocutaneous flap.
Ann Plast Surg.
1981;
7
272-280
Ömer ÖzkanM.D.
Akdeniz Üniversitesi Hastanesi, Plastik ve Rekonstrüktif Cerrahi Anabilim Dali
B Blok kat 5, Antalya, Turkey