Crush injury Heel and foot - Free Latissimus dorsi flap with skin graft




Crush injury of left foot with loss of heel skin and fat pad with loss of skin over dorm. 
Free Latissimus dorsi flap was planned and Colour doppler of the left lower limb was done to screen for vascularity and was normal.
CT- Angiography couldn't be done to raised creatinine levels.
Intraoperatively Anterior tibial vessels were found to be hypoplastic. Posterior tibial vessels were hardened and atherosclerotic.
An End to side anastomosis was done with posterior tibial artery. 
Patient was kept on blood thinners for 3 months to prevent thrombosis.
A well healed flap with normal function of the limb achieved.

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