Free Latissimus Dorsi–Groin Flap With Arteriovenous Loop for Reconstruction in Severe Lower Limb Crush Injury

Summary: Severe trauma can result in extensive soft-tissue defects that cannot be covered by local, pedicle, or single free flaps. Herein, we report a case of a lower leg crush injury caused by a 700-kg object, resulting in massive soft-tissue loss in a 46-year-old male patient who had undergone revascularization and was left with a single-vessel tibial runoff (posterior tibial artery). To avoid the compromised injury zone, reconstruction was performed using an arteriovenous loop and a free latissimus dorsi–groin combined flap. The postoperative course was favorable, with successful limb coverage and functional preservation. This approach may be a valuable reconstructive option for managing extensive soft-tissue defects in severe lower extremity trauma, in which the injury zone must be bypassed and a longer reach to suitable recipient vessels is often required.