CC BY-NC-ND 4.0 · Indian J Plast Surg 2016; 49(01): 95-98
DOI: 10.4103/0970-0358.182250
Case Report
Association of Plastic Surgeons of India

Double free-flap for a bimalleolar defect of lower leg and ankle

Naren Shetty
Department of Plastic Surgery, St. John’s Medical College, Bengaluru, Karnataka, India
,
Narendra S. Mashalkar
Department of Plastic Surgery, St. John’s Medical College, Bengaluru, Karnataka, India
,
Sunder Raj Ellur
Department of Plastic Surgery, St. John’s Medical College, Bengaluru, Karnataka, India
,
Karishma Kagodu
Department of Plastic Surgery, St. John’s Medical College, Bengaluru, Karnataka, India
› Author Affiliations
Further Information

Address for correspondence:

Dr. Naren Shetty
Department of Plastic Surgery, St. John’s Medical College Hospital
Sarjapur Road, Koramangala, Bengaluru - 560 034, Karnataka
India   

Publication History

Publication Date:
13 August 2019 (online)

 

ABSTRACT

Double free-flaps are necessary when tissue cover cannot be sufficed with a single flap. The other factors to be considered when using two free flaps for resurfacing of distal limb defects are the availability of more than one recipient vessel, the risk of distal limb ischaemia and the donor site morbidity of double flap harvest. If these factors are adequately addressed, double free-flaps can be safely executed for resurfacing distal limb defects with minimal morbidity. We report the simultaneous harvest and transfer of the anterolateral and anteromedial thigh flaps inset and vascularised as double free-flaps to resurface a large bimalleolar defect in a 14-year-old boy with no additional morbidity as compared to that of a single free tissue transfer.


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Conflicts of interest

There are no conflicts of interest.

  • REFERENCES

  • 1 Liu L, Zou L, Cao X, Cai J. Two different flaps for reconstruction of gunshot wounds to the foot and ankle in a child. J Pediatr Surg 2012; 47: E13-7
  • 2 Caddick JF, Peach H, Burge TS. Distally based double paddle fasciocutaneous island flap following lower limb trauma. Br J Plast Surg 2003; 56: 712-4
  • 3 Lin YT, Lin CH, Wei FC. More degrees of freedom by using chimeric concept in the applications of anterolateral thigh flap. J Plast Reconstr Aesthet Surg 2006; 59: 622-7
  • 4 Hwang KT, Kim YH. Double skin perforator flaps for aesthetic resurfacing of extensive limb defects. J Plast Reconstr Aesthet Surg 2015; 68: e47-9
  • 5 Wang WH, Deng JY, Xu B, Zhu J, Xia B, Zhang BJ. Double anterior (anterolateral and anteromedial) thigh flap for oral perforated defect reconstruction. J Craniomaxillofac Surg 2014; 42: 2041-4
  • 6 Cigna E, Chen HC, Ozkan O, Sorvillo V, Maruccia M, Ribuffo D. The anteromedial thigh free flap anatomy: A clinical, anatomical, and cadaveric study. Plast Reconstr Surg 2014; 133: 420-9
  • 7 Riva FM, Tan NC, Liu KW, Hsieh CH, Jeng SF. Anteromedial thigh perforator free flap: Report of 41 consecutive flaps and donor-site morbidity evaluation. J Plast Reconstr Aesthet Surg 2013; 66: 1405-14
  • 8 Park S, Han SH, Lee TJ. Algorithm for recipient vessel selection in free tissue transfer to the lower extremity. Plast Reconstr Surg 1999; 103: 1937-48
  • 9 Tsai YT, Lin TS. The suitability of end-to-side microvascular anastomosis in free flap transfer for limb reconstruction. Ann Plast Surg 2012; 68: 171-4
  • 10 Kim JT, Kim CY, Kim YH. T-anastomosis in microsurgical free flap reconstruction: An overview of clinical applications. J Plast Reconstr Aesthet Surg 2008; 61: 1157-63

Address for correspondence:

Dr. Naren Shetty
Department of Plastic Surgery, St. John’s Medical College Hospital
Sarjapur Road, Koramangala, Bengaluru - 560 034, Karnataka
India   

  • REFERENCES

  • 1 Liu L, Zou L, Cao X, Cai J. Two different flaps for reconstruction of gunshot wounds to the foot and ankle in a child. J Pediatr Surg 2012; 47: E13-7
  • 2 Caddick JF, Peach H, Burge TS. Distally based double paddle fasciocutaneous island flap following lower limb trauma. Br J Plast Surg 2003; 56: 712-4
  • 3 Lin YT, Lin CH, Wei FC. More degrees of freedom by using chimeric concept in the applications of anterolateral thigh flap. J Plast Reconstr Aesthet Surg 2006; 59: 622-7
  • 4 Hwang KT, Kim YH. Double skin perforator flaps for aesthetic resurfacing of extensive limb defects. J Plast Reconstr Aesthet Surg 2015; 68: e47-9
  • 5 Wang WH, Deng JY, Xu B, Zhu J, Xia B, Zhang BJ. Double anterior (anterolateral and anteromedial) thigh flap for oral perforated defect reconstruction. J Craniomaxillofac Surg 2014; 42: 2041-4
  • 6 Cigna E, Chen HC, Ozkan O, Sorvillo V, Maruccia M, Ribuffo D. The anteromedial thigh free flap anatomy: A clinical, anatomical, and cadaveric study. Plast Reconstr Surg 2014; 133: 420-9
  • 7 Riva FM, Tan NC, Liu KW, Hsieh CH, Jeng SF. Anteromedial thigh perforator free flap: Report of 41 consecutive flaps and donor-site morbidity evaluation. J Plast Reconstr Aesthet Surg 2013; 66: 1405-14
  • 8 Park S, Han SH, Lee TJ. Algorithm for recipient vessel selection in free tissue transfer to the lower extremity. Plast Reconstr Surg 1999; 103: 1937-48
  • 9 Tsai YT, Lin TS. The suitability of end-to-side microvascular anastomosis in free flap transfer for limb reconstruction. Ann Plast Surg 2012; 68: 171-4
  • 10 Kim JT, Kim CY, Kim YH. T-anastomosis in microsurgical free flap reconstruction: An overview of clinical applications. J Plast Reconstr Aesthet Surg 2008; 61: 1157-63