Complex bone and soft tissues defect reconstruction with a chimeric flap: Latissimus dorsi, serratus anterior and ribs: Case report

Abstract

Treatment of tibial defects with important soft tissue involvement after bilateral lower limb trauma are challenging for both orthopedic and plastic surgeons. Several therapeutic options are described in armamentarium of reconstructive surgeons such as bone grafts, bone substitutes, distractions osteogenesis, limb prosthesis, free flaps, negative pressure therapy and unfortunately amputation. We describe a patient with tibial and soft tissue defect reconstructed using a chimeric flap composed of latissimus dorsi, serratus anterior muscle and two ribs. At the 1-year follow-up the patient is able to walk with a walker and is still enrolled in rehabilitation program.

Keywords: Chimeric flap; Latissimus dorsi; Serratus anterior; Soft tissue defect; Tibial bone defect; Vascularized ribs.