Chimeric Functional Latissimus Flap Transfer to Restore Ankle Dorsiflexion following a Traumatic Defect of the Lower Leg: A Case Report

The reconstructive challenges to a devastating lower extremity injury include achieving bony stability, soft tissue coverage, restoring or improving function, and eventually achieving skin closure. Techniques including vascularized and nonvascularized bone grafting are well-described approaches in attaining bony stability of the lower extremity.[1] Free composite tissue transfer can achieve coverage of bony prosthetic material with healthy wound healing, but often fails to address the functional aspect of the lower limb. Functional restoration of the lower extremity has been shown to increase patient quality of life and may reach comparable levels to that of the normal population.[2] Cost-utility analysis shows that costs of amputation far exceed limb salvage independent of ongoing prosthesis needs.[3] Although this may prove to be a difficult task, encouraging results are seen with functional muscle transfer.[4] [5] [6] [7] Recently, the chimeric flap has gained popularity in its unique ability to restore composite defects of the lower extremity while maintaining economic tissue use and low donor-site morbidity. We present a case of a large composite defect of the anterior leg successfully repaired with a free chimeric functional latissimus dorsi flap resulting in functional dorsiflexion that has not previously been reported.

• References

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