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Cross-Leg Free Flap: Crossing the Border Zone of Ischemic Limb. A Case Report of Limb Salvage Procedure following a Delayed Diagnosis of Popliteal Artery Injury
Vascular injury following traumatic knee injury quoted in the literature ranges from 3.3 to 65%, depending on the magnitude and pattern of the injury. Timely recognition is crucial to ensure the revascularization is done within 6 to 8 hours from the time of injury to avoid significant morbidity, amputation, and medicolegal ramifications. We present a case of an ischemic limb following delayed diagnosis of popliteal artery injury after knee dislocation. Even though we have successfully repaired the popliteal artery, the evolving ischemia over the distal limb poses a reconstruction challenge. Multiple surgical debridement procedures were performed to control the local tissue infection. Free tissue transfer with chimeric latissimus dorsi flap was done to resurface the defect. However, the forefoot became gangrenous despite a free muscle flap transfer. His limb appeared destined for amputation in the vicinity of tissue and recipient vessels, but we chose to use a cross-leg free flap as an option for limb salvage.
Conceptualization: I.H.Y. , W.A.W.S., A.S.H., W.F.N.W.I.
Data curation: L.H.Y., W.A.W.S., A.S.H., W.F.N.W.I.
Formal analysis: L.H.Y., W.A.W.S., A.S.H., W.F.N.W.I.
Methodology: L.H.Y., W.A.W.S., A.S.H., W.F.N.W.I.
Project administration: L.H.Y., W.A.W.S., A.S.H., W.F.N.W.I.
Writing – original draft: L.H.Y.
Writing – review and editing: all authors.
Written consent has been obtained from patient.
Received: 04 July 2022
Accepted: 13 October 2022
Accepted Manuscript online:
17 October 2022
Article published online:
07 February 2023
© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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