Journal of Japanese Society of Reconstructive Microsurgery
Online ISSN : 2185-9949
Print ISSN : 0916-4936
ISSN-L : 2185-9949
Case Report
Why Choose an LD-SA Combined Flap for Severe Open Fractures of the Lower Extremity?
Masayuki HASEGAWAKentaro FUTAMURAMasahiro NISHIDA
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2025 Volume 38 Issue 2 Pages 62-67

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Abstract

 Purpose: This study evaluated the treatment outcomes of soft tissue reconstruction using a free serratus anterior-latissimus dorsi combined flap for Gustilo type IIIB/C open fractures of the lower limb. 
 Methods: A retrospective study was conducted on nine male patients treated at our center between 2013 and 2023. The primary and secondary outcomes were flap survival, flap complications, donor-site morbidity, bone union, walking ability, and NRS scores. 
 Results: The median patient age was 43 years. Soft-tissue defects involved two or three anatomical regions. The flaps survived in eight cases; however, one case had complete necrosis, and another case required an additional flap due to ulcer formation. One patient experienced residual muscle weakness around the shoulder. Bone union was achieved in all the cases. Eight patients were able to walk independently, and the NRS scores ranged from 0 to 2. 
 Discussion: Free combined serratus anterior-latissimus dorsi flaps are reliable and effective for reconstructing extensive soft tissue defects and offer broad coverage and technical simplicity.

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© 2025 Japanese Society of Reconstructive Microsurgery
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