A: The 25-year-old patient had a severe crush injury to his right lower

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Download scientific diagram | A: The 25-year-old patient had a severe crush injury to his right lower limb in a car accident. The leg survived after thrombectomy of the right femoral artery. There was a 12 cm defect of the right tibia after debridement, and the fractured fibula was plated as shown; B: there was no available recipient artery in the thigh and leg. In the first stage operation, a radial forearm flap was used as a vascular bridge flap, it was connected to the posterior tibial artery of the left leg in end-to-side fashion; C: in the second stage operation, a free flap was harvested from the back, including myocutanous latissimus dorsi and the lower part of serratus muscle, carrying two ribs (6th and 8th); D: the flaps were connected to the free end of radial forearm flap. The two legs were temporarily bound together with an external skeletal fixator; E: four weeks later, the bridge was divided and part of the radial forearm flap was used for coverage of the residual defect of the right leg; F: bone union was achieved and, with proper physiotherapy, the right leg was gradually trained to resume weight-bearing. As shown, the ribs increased thickness, in a long term follow up from publication: Advances in microsurgery for upper and lower extremity reconstruction and limb preservation | In the recent decades, microsurgical reconstruction has evolved from simple survival of the affected extremity to the improvement of functional and aesthetic outcome. This review retraces the main contributions to the advances of microsurgery for reconstruction of upper and | Extremities, Reconstruction and Free Tissue Flaps | ResearchGate, the professional network for scientists.