Latissimus dorsi and/or serratus anterior - rib composite flap for posttraumatic long bones reconstruction

Posttraumatic bone defects or their sequels represent one of the most challenging problems in limbs reconstruction. It is proved that due to their advantages, i.e. regenerative properties, shorter time to obtain bone fusion, better stability, better power to fight against infection, the use of vascularized bone grafts (VBGs) represents the best choice in such cases. If large soft tissue defects are concomitant to bone defects, composite flaps including bone segments should be the choice. This paper provides details about such flaps - vascularized rib (R) as part of the latissimus dorsi (LD) and/or serratus anterior (SA) flap. In all alternatives, i.e. LD-R, SA-R, and LD-SA-R, the flap can be used as a free flap in both upper and lower limb, or as a pedicled flap in upper extremity. We hypothesized that these flaps could offer the same advantages and possible results as other VBGs.