Successful five flap reconstruction for extensive crush injuries of bilateral lower limbs using local pedicled flaps in a 73-year-old patient: a rare case report

Tanveer A. Bhat; Hisham Alokaili; Othillah Moazin; Fatima O. A. Daker; Danah Alkadi; Abdulla S. Altamimi; Mohammed Y. Mirza

doi:10.18203/2349-2902.isj20233001

Authors

Tanveer A. Bhat Department of Plastic Surgery and Burns, King Saud Medical City (KSMC), Kingdom of Saudi Arabia
Hisham Alokaili Department of Plastic Surgery and Burns, King Saud Medical City (KSMC), Kingdom of Saudi Arabia
Othillah Moazin Department of Plastic Surgery and Burns, King Saud Medical City (KSMC), Kingdom of Saudi Arabia
Fatima O. A. Daker Department of Plastic Surgery and Burns, King Saud Medical City (KSMC), Kingdom of Saudi Arabia
Danah Alkadi Department of Plastic Surgery and Burns, King Saud Medical City (KSMC), Kingdom of Saudi Arabia
Abdulla S. Altamimi Department of Plastic Surgery and Burns, King Saud Medical City (KSMC), Kingdom of Saudi Arabia
Mohammed Y. Mirza Department of Plastic Surgery and Burns, King Saud Medical City (KSMC), Kingdom of Saudi Arabia

DOI:

https://doi.org/10.18203/2349-2902.isj20233001

Keywords:

Crush injury, Debridement, Pedicled muscle flaps, Soft tissue reconstruction

Abstract

Extensive soft tissue defects with periosteal stripping over critical areas of tibia pose a tough challenge to the reconstructive plastic surgeon. Treatment of choice for these defects is free tissue transfer. Local pedicled fasciocutaneous or muscle flaps are used only when the free tissue transfer is not possible. The gastrocnemius and soleus flaps either raised as a combined flap or as individual separate flaps can be used in selected cases after a meticulous preoperative planning. Here we report a 73-year-old male patient a case of extensive crush injuries involving both lower limbs following a motor vehicle accident (MVA) in whom we have successfully reconstructed the extensive soft tissue defects with exposed tibia with five local pedicled flaps. The purpose of writing this case report is that when free tissue transfer is not possible in patients with such extensive crush injuries, a durable functionally and cosmetically acceptable reconstruction with pedicled hemi medial gastrocnemius and proximally based medial hemisoleus flaps can be done after a meticulous planning and flap design without any significant functional donor site morbidity.

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