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We introduce a treatment that combines the cross-leg free flap with the Masquelet technique and describe two cases using this method for bone and soft tissue reconstruction. Both patients were successfully treated and ambulatory. This novel method can be safely performed using the delay technique, indocyanine-green angiography and near-infrared spectroscopy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8986292 | PMC |
http://dx.doi.org/10.1080/23320885.2022.2039667 | DOI Listing |
J Clin Orthop Trauma
November 2025
Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background: Complex lower limb injuries involving soft tissue defects, fractures, and vascular compromise present significant reconstructive challenges. Free tissue transfer is often the gold standard for reconstruction; however, reverse sural cross-leg flaps provide a reliable alternative in resource-limited settings or when the recipient's vessels are compromised. This case series highlights the utility of this technique in challenging scenarios, including comminuted fractures, vascular injuries, and extensive soft tissue defects.
View Article and Find Full Text PDFInt J Surg Case Rep
September 2025
Wazir Mohammad Akbar Khan (WMAK) hospital, Kabul, Afghanistan. Electronic address:
Introduction: Blast injuries to the lower extremities often result in extensive soft tissue damage and are prone to complications such as infection and, rarely, maggot infestation. These challenges can jeopardize limb salvage, especially in resource-limited settings. We report a successfully managed case of a neglected anterior ankle blast wound complicated by infection and myiasis, treated with a multidisciplinary approach incorporating sunlight exposure and a cross-leg flap.
View Article and Find Full Text PDFAnn Plast Surg
June 2025
Plastic, Reconstructive and Aesthetic Surgery, Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
Background: Cross-leg free flaps (CLFFs) and cross-leg cable bridge flaps (CLCBFs) are essential techniques in reconstructive surgery for complex lower limb defects when local options or suitable recipient vessels are unavailable. Although the surgical approaches are well established, standardized protocols for flap division, ischemic preconditioning, and perfusion assessment are lacking.
Methods: This study presents a systematic review of the literature on CLFFs and CLCBFs, focusing on division timing, conditioning methods, and perfusion evaluation.
Microsurgery
May 2025
Department of Surgery, Wyckoff Heights Medical Center, New York, New York, USA.
Int J Surg Case Rep
February 2025
Department of Plastic Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Introduction: Soft tissue defect in the lower limb presents as a difficult reconstructive challenge. Cross-leg flap was routinely used in the past for the salvage of the lower limb but is seldom used nowadays due to advances in microsurgical procedures.
Case Presentation: We present a case of an 18-year-old male who presented with a complex soft tissue defect of 25 × 10 cm on the anterolateral aspect of the right leg following a motor vehicle accident.