Lower limb salvage in Gustillo Type III-b distal tibial fracture with a free flap transfer using loupe magnification – a case report

Abstract

Background: Reconstruction of crushed distal tibia is a challenging ordeal to a plastic surgeon which involved a protracted course of management. Free flaps are often the only viable option to provide a soft tissue cover over exposed and fractured bone.
Patient and Result: We present a case of 32 years old male with Gustillo Type III B fracture of lower end of tibia in whom the limb was salvaged by transferring a free latisimmus dorsi muscle flap. The microvascular anastomosis was carried out using binocular loupe magnification. Outcome was satisfactory although there was a prolonged hospital stay.
Conclusion: Free flaps can be safely transferred using commonly available optical loupes.

Key words: Open tibial fracture, free flap, amputation, limb salvage, binocular loupe magnification.