Thoracic limb salvage by fibular free flap


  • Rodrigo Banegas Ruiz Department of Traumatology, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX, Mexico
  • Alan I. Valderrama Treviño Laboratory of Experimental Immunotherapy and Tissue Engineering, Faculty of Medicine, UNAM, CDMX, Mexico
  • Francisco Fabián Gómez Mendoza Department of Hand Surgery, Central Military Hospital, CDMX, Mexico
  • Rodrigo A. Mendoza Aceves Department of Anesthesiology, Angeles del Pedregal Hospital, CDMX, Mexico
  • Rigoberto Román Hernández Department of Peripheral Vascular Surgery, Central Military Hospital, CDMX, Mexico
  • Ismael Vejar Alba Department of Maxillofacial Surgery, Central Military Hospital, CDMX, Mexico
  • Fernando Gómez Verdejo Resident of the Articular Surgery Subspecialty, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX, Mexico
  • José Antonio Rivas Montero Service of Hand Surgery and Microsurgery, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX, Mexico
  • Karolina Ortega López Medical Intern, Central Military Hospital, CDMX, Mexico
  • Yuri Jiménez Caprielova Faculty of Medicine, UNAM, CDMX, Mexico
  • Leonel Dalain Hernández Arteaga Faculty of Medicine, Autonomous University of Quteretaro, Mexico
  • Emilio Pérez Ortega Faculty of Medicine, UNAM, CDMX, Mexico
  • Baltazar Barrera Mera Department of Physiology, Faculty of Medicine, UNAM, CDMX, Mexico



Amputation, Complex trauma, Fibular free flap, Fracture, Microsurgery, Microvascular flap


The treatment of most fractures of the ulna and radius is usually performed by anatomical reduction and internal fixation, when damage is extensive and local soft tissue cannot provide a complete wound coverage, locoregional flaps present a suitable reconstructive benefit. A 35-year-old male patient suffered an exposed diaphysio-metaphyseal fracture with multi-fragmented distal radius. The patient was evaluated during a 10-day period at the National Institute of Rehabilitation, where the osteosynthesis material and a severe infectious process with necrosis were identified. Necrosectomy of the posterior compartment and removal of the osteosynthesis material was performed, a skin defect of approximately 22x16 cm was observed with a bone gap of 6 cm of radius and ulna. a fibula-free flap is placed to correct the skin defect and an external fixative used for bone alignment. The fibular free flap presents an excellent therapeutic alternative in the resolution of bone gaps with extensive skin defect. Whenever a trained microsurgery team is available, current scales of limb injury should be considered but not utilized for therapeutic approach, always trying to shift amputation as the first option, to the very last one of them.


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How to Cite

Ruiz, R. B., Valderrama Treviño, A. I., Gómez Mendoza, F. F., Mendoza Aceves, R. A., Hernández, R. R., Alba, I. V., Verdejo, F. G., Rivas Montero, J. A., López, K. O., Caprielova, Y. J., Arteaga, L. D. H., Ortega, E. P., & Mera, B. B. (2019). Thoracic limb salvage by fibular free flap. International Journal of Research in Medical Sciences, 8(1), 351–354.



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