Reconstruction of a Massive Traumatic Necrotizing Wound With Contiguous Anterior Thigh and Lower Leg Fillet Flap With Leg and Hemipelvic Amputation

Abstract

Reconstruction of massive soft tissue defects is challenging in the setting of polytrauma. We present a case report of a polytrauma patient with an open acetabulum fracture with a necrotizing wound that was managed with a hemipelvectomy and contiguous thigh and leg fillet flap. The harvest of the entire leg flap was utilized due to the presence of a high cervical spine injury that rendered the lower extremities non-functional. The patient’s tenuous medical status was normalized once the necrotizing wound was covered, and subsequent complications related to the flap were minimized. The patient currently enjoys a reasonable quality of life consistent with that of a C7 quadriplegic.