Published: 2019-04-26

Antebrachial microvascular flap for reconstruction of the pelvic limb: case report

Rodrigo Banegas-Ruiz, Alan I. Valderrama-Treviño, J. A. Rivas-Montero, F. F. Gómez-Mendoza, E. García-Martínez, C. R. Baca Domínguez, G. Campos-Angulo, L. F. Alejo-Fuentes, L. R. García-Valadez, C. N. Jiménez-Nateras, V. M. Ramos-Lojero, J. A. Espejel-Blancas, C. A. Méndez Celis, Baltazar Barrera-Mera


Complex defects in the soft tissues of the foot and ankle caused by high-energy trauma, infection, cancer or diabetes require rapid and effective treatment which decreases the risk of infection, bone healing time, hospital stay and number total of surgical approaches. Authors report a clinical case of a 23-year-old female patient who suffers high-energy trauma due to a motorcycle accident which causes exposure of the distal third of the tibia, loss of the tibial joint face, and loss of tissue throughout the region of the malleolus medial of the right pelvic extremity. Tissue transfer to the pelvic limb is performed using left contralateral radial antebrachial free flap as donor area. This case report aims to emphasize the key aspects of the high energy trauma approach by using microvascular flaps, as well as the satisfactory evolution of the patient that directly affects the prognosis for life and function.


Donor zone, High energy trauma, Radial artery, Receiving zone, Radial microvascular flap

Full Text:



Maruccia M, Elia R, Caizzi G, Carrozzo M, Vicent G, et al. Free flap and kickstand external fixator in foot and ankle soft tissue reconstruction. The versatility of a microsurgical- friendly application of an orthopedic device. Injury. 2018;49(3):105-9.

Matthew E, Ivica, D, Christopher A. Free tissue transfer for limb salvage in high- risk patient: worth the risk. Adv Wound Care. 2013;2(2):63-8.

Alexis D, Karen E, Hyuma A, Ram K, Ido B, Ketan M, et al. Functional outcomes of traumatic lower extremity reconstruction. J Clinic Orthopaed Trauma. 2019;10:178-81.

Panayotis N, Aristides B, Anastasios V, Marios D. Versatility of the island forearm flap in the management of extensive skin defects of the hand. Injured. 2008;39:49-56.

Andrades P, Danilla S, Benítez S, Erazo C, Sepúlveda S. Colgajo radial: experience of the plastic surgery team of the University of Chile. Chilean J Surg. 2011;63(5):459-67.

M Henry T, Jih H, Yuzaidi M, Affirul C, Rizal I, Tuan N. Clinical characteristics of 1653 injured motorcyclists and factors that predict mortality from motorcycle crashes in Malaysia; Chinese J Traumatol. 2018;S1008-1275(18):30223-2.

Lingyun X, Emre G, Thomas K, Frederick J, Leila H, Michel S, et al. Free flaps for reconstruction of soft tissue defects in lower extremity: a meta-analysis on microsurgical outcome and safety; Microsurg. 2016;36:511-24.

Antonio C, Leandro V, Marina T, Marcelo R, Ivan C. The radial artery´s sacrifice in the Chinese flap is not deleterious to patients. Hand. 2016;11(3):357-632.

Riecke B, Kohlmeier C, Kreiker H, Suling A, Assaf AT, Wikner J, et al. Long-term biomechanical analysis of donor site morbidity after radial forearm free flap. J Cranio Maxillofacial Surg. 2015;43(9):1776-80.

Victor M, Thierry B, Bérengére C, Younes R, Tarik I, Emad D, et al. The radial forearm free flap: review of microsurgical options; J Plastic Aesthet Surg. 2009;62:5-10.

Lawrence J, Gottlieb MD, Radial Forearm. Clin Plastic Surg. 2018;45(3):391-8.

Giordano L, Bondi S, Ferrario F, Fabiano B, Bussi M. Radial forearm free flap surgery: a modified skin- closure technique improving donor- site aesthetic appearence; Acta Otorhinolaryngologica Italica. 2012;32;158-63.

Yong H, Woong N, In-ho C, Hyung J. Revisiting radial forearm free flap for succesful venous drainage. Maxilofacial Plastic Reconstructive Surg. 2017;39(1):14.

Kai M, Michael S, Günter G. The evolution of the pedicled radial forearm flap. Hand. 2010;5:37-42.