Salvage of a lower extremity by microsurgical transfer of tibial bone from the contralateral extremity traumatically amputated at the ankle level

Ann Plast Surg. 2009 Oct;63(4):389-92. doi: 10.1097/SAP.0b013e31819537c9.


The authors present a case of free vascularized transfer of the tibial bone as an osteomyocutaneous flap based on the posterior tibial vessels. A 42-year-old man presented with severe crush injury to bilateral legs. The left tibial bone and soft tissue defect required reconstruction with an osteomyocutaneous free flap. Since the contralateral leg was traumatically amputated at the level of the ankle, a decision was made to harvest a free tibial osteomyocutaneous flap with below-knee-amputation completed. The transfer was achieved successfully with complete survival of the flap and bony union. This report describes the technical and healing aspects of such a unique transfer which may rarely be indicated.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic
  • Adult
  • Amputation, Traumatic / surgery*
  • Ankle / surgery
  • Bone Transplantation / methods
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Injury Severity Score
  • Leg Injuries / pathology
  • Leg Injuries / surgery
  • Lower Extremity / injuries
  • Male
  • Microsurgery / methods*
  • Reconstructive Surgical Procedures / methods
  • Regional Blood Flow
  • Salvage Therapy*
  • Surgical Flaps / blood supply*
  • Tibia / blood supply
  • Tibia / surgery
  • Tibia / transplantation*
  • Tissue and Organ Harvesting
  • Treatment Outcome