Difficult reconstruction of an extensive injury in the lower extremity with a large cross-leg microvascular composite-tissue flap containing fibula.

In the absence of proper recipient vessels, a large microvascular composite-tissue flap was transferred successfully for reconstruction of a leg with an extensive crush injury. This was accomplished by using vessels of the normal leg. The microvascular flap containing skin, muscle, and 15 cm of fibula survived well after division of the pedicle. To achieve good bone healing, the leg was protected by a brace while gradually increasing weight bearing. The functional result is satisfactory.