A salvage composite free flap for improved prosthetics

Abstract

A post-traumatic composite skin, muscle and bone defect in the left thigh with a 14-cm bone gap in the femur was secondarily reconstructed with a salvage osseomyocutaneous microvascular free tissue transfer of the tibia (18 cm), calf muscles and overlying skin (26×13 cm) harvested from the lower leg. The latter was amputated for chronic trophic ulceration of the foot and causalgia resulting from damage to the femoral and sciatic nerve in the primary injury. This situation resulted in an above-the-knee amputation stump with a better fitting and a more convenient prosthesis, rather than amputation at the hip joint.