[Combined Latissimus dorsi and Serratus anterior reverse flow pedicle flap. Report of a clinical case]. / Le lambeau musculaire combiné grand dorsal--grand dentelé pédiculé à rétro. A propos d'un cas clinique.

The authors report a new local combined flap involving the distally based Latissimus dorsi muscle pedicled on the lumber perforating arteries and prolonged by the last three digitations of the Serratus anterior muscle supplied by the thoracic branch of the thoraco-dorsal artery. This artifice, never previously described, increased the bulk and arc of rotation of the dorsalis flap. It was thus possible to cover a wide defect on the posterior aspect of the sacro-iliac region in a patient previously operated for a highly malignant histiocytofibroma. The anatomic considerations, harvesting technique and advantages and drawbacks of this flap are discussed.

[Coverage of post-traumatic complex substance loss on the leg. Apropos of a series of 35 cases]. / La couverture des pertes de substance post-traumatiques complexes de la jambe. A propos d'une série de 35 cas.

Thirty-five patients with complex post-traumatic leg defects were treated surgically between 1986 and 1992. 10 of these patients had severe open fractures (Gustillo III a, b and c), 25 others suffered from cutaneous and bony sequelae. The choice of the various covering flaps is discussed according to the place and type of defect and also according to their trophic properties. In the light of their own experience and a review of the recent literature, the authors stress the necessity of covering the defect as soon as possible, particularly when a free flap is indicated. Muscle flaps are preferred. Bony reconstruction can then be achieved by a conventional graft.