Trunk & Lower Extremity Reconstruction

For an open tibial fracture (Gustilo IIIB) with exposed bone and segmental loss, the current best-practice timing for definitive soft-tissue coverage is:

In lower-third tibial defects with exposed bone/tendon, the most reliable local/pedicled flap is:

A through-and-through heel pad loss (plantar, weight-bearing) requires coverage that best restores sensate glabrous tissue. Preferred option:

In traumatic mid-tibial exposure with long segment (>8 cm) soft-tissue loss and healthy vessels, a versatile free flap is:

Most appropriate initial antibiotics for Gustilo III open tibia (farm injury/soil contamination):

Principle of biopsy for suspected soft-tissue sarcoma of the thigh:

Recommended wide excision margin for most high-grade extremity soft-tissue sarcomas when feasible:

For chronic osteomyelitis in tibia with draining sinus after failed hardware, first reconstructive step:

Muscle vs fasciocutaneous flaps for tibial osteomyelitis: which is TRUE?

Distal tibia free-flap recipient artery choice to preserve limb perfusion:

For degloving injury of the foot dorsum with avulsed skin still viable, an evidence-based option is:

Optimal negative-pressure wound therapy (NPWT) role in open tibia prior to flap:

“Fix-and-flap” concept refers to:

For proximal third tibial exposure over patellar tendon, the best local muscle flap is:

Hallmark complication risk with distally based reverse sural flap:

For heel weight-bearing ulcers in neuropathic diabetics, offloading cornerstone is:

Amputation level selection in ischemic limb: most critical determinant of healing is:

Below-knee amputation (BKA) technique that improves distal stability:

Ertl BKA modification adds:

Indication for primary amputation rather than limb salvage in mangled limb:

For a large sacral pressure ulcer with exposed bone but ambulatory potential, best flap:

Ischial pressure ulcers commonly require:

Trochanteric pressure sore reconstruction workhorse:

In abdominal wall reconstruction of large midline hernia with poor medial advancement, the posterior component separation technique is:

In contaminated ventral hernia, most appropriate mesh strategy is:

Chest wall full-thickness defect >5 cm involving multiple ribs needs:

Sternal wound dehiscence with mediastinitis after cardiac surgery—reconstructive mainstay:

Donor-site morbidity lowest among these trunk flaps typically with:

Lumbar artery perforator (LAP) flap is most useful for:

For posterior thigh/gluteal defects, reliable perforator options include:

Keystone perforator island flap is characterized by:

Propeller perforator flap (180°) key pitfall:

Chimeric ALT flap advantage in leg reconstruction:

Free fibula for segmental tibial reconstruction after debridement (Masquelet/orthoplastic) often needs:

For extensive lower-extremity defects in polytrauma with limited recipient veins, anastomotic strategy:

Best practice to reduce DVT in long lower-extremity free-flap cases:

Predictors of reverse sural flap failure include:

When resurfacing Achilles tendon exposure in athletes, preferred tissue:

After free flap to tibia, best early monitoring sign of venous compromise:

Cross-leg flap is most appropriate when:

Best reconstruction for a large perineal/pelvic dead-space defect after APR in an irradiated field is:

Exposed femoral vessels after groin dissection/infection—workhorse immediate coverage:

Extensive scrotal skin loss (>50%) with viable testes and clean wound—preferred coverage:

Fournier’s gangrene initial management priority is:

Groin/perineal hidradenitis suppurativa definitive treatment:

The medial plantar (instep) flap is supplied and sensate via:

In the Masquelet (induced membrane) technique for segmental tibial loss, stage 2 timing is:

Key benefit of antibiotic PMMA bead/spacer in infected tibial defects:

Indication favoring Ilizarov bone transport over immediate grafting:

For skin graft success to the leg, the most critical factors include:

Achilles tendon exposure without paratenon—optimal coverage:

In a distal-third leg defect with single-vessel runoff, the safest arterial anastomosis for free flap is:

“Flow-through” flap anastomosis is most useful when:

Use of interposition vein grafts in lower-extremity free flaps:

First-line therapy for cancer- or surgery-related lower-limb lymphedema:

Best candidates for lymphaticovenous bypass (LVB):

A common donor site for vascularized lymph node transfer (VLNT) with low donor-site lymphedema risk:

Penile shaft skin loss after debridement with clean corporal coverage—best resurfacing:

Recurrent perineal urethrocutaneous fistula in irradiated field—helpful adjunct flap:

Knee soft-tissue coverage after TKA infection with exposed patellar tendon—preferred local flap:

ALT flap pedicle is a branch of the:

Major sensory morbidity to counsel with ALT harvest:

Safe ALT thinning principle:

Optimal timing window to salvage a thrombosed lower-limb free flap: