Provision of soft-tissue coverage for defects in the distal leg and foot is a challenge, especially in patients with multiple injuries and major soft-tissue defects. Major flap reconstruction requires expertise and the results are variable, with high morbidity. We report a case in which a reverse flow sural fasciocutaneous flap was used for treatment of an open fracture-dislocation of the right ankle after repeated debridement in a 64-year-old man with a history of chronic smoking, diabetes mellitus, and hypertension.
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