J Reconstr Microsurg Open 2016; 01(02): 117-121
DOI: 10.1055/s-0036-1593404
Case Report
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Free Flap Salvage in Lower Extremity Reconstruction via Use of Contralateral Lower Extremity Recipient Vessels

Katelyn G. Bennett
1  Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
,
Brian P. Kelley
1  Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
,
Theodore A. Kung
1  Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
,
Adeyiza O. Momoh
1  Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
› Author Affiliations
Further Information

Publication History

01 August 2016

08 August 2016

Publication Date:
27 September 2016 (eFirst)

  

Abstract

Soft-tissue coverage after complex distal lower extremity trauma is often difficult due to limited local flap options and injury to potential recipient vessels when considering microsurgical reconstruction. Therefore, obtaining recipient vessels outside the zone of injury to optimize successful free tissue transfers remains a basic tenet of microsurgery. We present a case of a crush injury to the lower extremity with open tibia and fibula fractures and a large soft-tissue defect that required reconstruction for limb salvage. Due to recipient vessel thrombosis within the affected extremity even well proximal to the zone of injury, contralateral lower extremity recipient vessels were used as an alternative for cross-leg flap limb salvage. We performed flap pedicle division 6 weeks after inset. Follow-up 9 months after reconstruction showed the patient achieving independent ambulation. In conclusion, cross-leg free flaps may be used as a last resort to successfully salvage flaps in the setting of poor ipsilateral recipient vessels and repeatedly occluding anastomoses.