Reconstruction of Lower Extremity Soft Tissue Defect using Cross-leg Free Flap

ABSTRACT

PURPOSE: To reconstruct soft tissue defect on lower extremity especially combined with osteomyelitis, free flap with enough blood supplies is required. There are some instance when patients have inadequate recipient vessels for microanastomosis. Anastomosis with harvested vein graft can solve the problem. It may be more problematic or even increase recipient site complication. Cross leg free flaps using contra-lateral vessel can be a solution. METHODS: From 2005 to 2008, 12 cases of cross leg free flap were done for 12 patients(9 male, 3 female). External fixators used in all cases. The free flaps used were laissmus dorsi muscle flap(n=5), anterolateral thigh flap(n=4), gracilis muscle flap(n=2) and medial plantar artery fasciotaneous flap(n=1). In all cases, contralateral posterior tibial artery and vein were used as recipient pedicle. RESULTS: All flaps survived without additional operative procedures. There happened no complications such as hematoma or Infection. Sometimes patients needed further therapeutic exercise for fast movement recovery. CONCLUSION: Although cross leg free flaps require long period of bed resting and rehabilitation after pedicle cutting, It can be a practical alternative for soft tissue defect on lower distal extremity with inadequate recipient vessels for free flap on affected leg.