Distally based posterior tibial artery cross-bridge flap for reconstruction of contralateral leg soft tissue defects

A cross-leg or cross-bridge free flap is frequently used for the reconstruction of leg defects in cases with no suitable recipient vessels in the vicinity of the defect. Here we report eight cases of leg reconstruction with a distally based posterior tibial artery cross-bridge flap without microvascular anastomosis technology. A distally based posterior tibial artery flap was elevated and used to reconstruct contralateral leg defects. A skin incision was made near the recipient wound to create a skin bridge, and a subcutaneous tunnel was made between the skin incision and the recipient wound for the vascular pedicle to pass over. All flaps survived completely without complications, except for a case with minor erosion in the donor site. Compared with a cross-leg or cross-bridge free flap, a distally based posterior tibial artery cross-bridge flap is reliable and versatile, leading to shorter operation duration and a lower risk of thrombosis in the vessel because microvascular anastomosis is not required.