title: Repair of a large soft tissue defect in the leg with cross-leg bridge free transfer of a latissimus dorsi myocutaneous flap: a case report.
abstract: A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue defect (27 cm multiply 7 cm). Doppler examination revealed the posterior tibial  artery was occluded due to thrombosis. Three weeks after injury, the latissimus dors myocutaneous flap was elevated with a T-shaped vascular pedicle and was interposed between the two vascular ends of the posterior tibial vessel of the contralateral leg. Two end to end anastomoses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap's T-shaped vascular pedicle. The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg. The vascular pedicle was cut off after 28 days and the flap survived completely. After 3-years'follow-up postoperatively, a good contour was confirmed at the recipient area. The right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was demonstrated patent by clinical and Doppler examinations.
authors.affiliation: Institute of Orthopaedics, General Hospital of Lanzhou Military Command of PLA, Lanzhou 730050, China.
authors.forename: Gong-lin
authors.initials: GL
authors.lastname: Zhang
authors.forename: Ke-ming
authors.initials: KM
authors.lastname: Chen
authors.forename: Jun-hua
authors.initials: JH
authors.lastname: Zhang
authors.forename: Shi-yong
authors.initials: SY
authors.lastname: Wang
mesh_terms: D000063:Accidents, Traffic; D000714:Anastomosis, Surgical; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D064171:Superficial Back Muscles / Q000637:transplantation*; D013524:Surgical Flaps; D013927:Thrombosis / Q000000981:diagnostic imaging; D016909:Tibial Arteries / Q000000981:diagnostic imaging; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D018608:Ultrasonography, Doppler