Journal of Plastic, Breast & Reconstructive Surgery

Case 1 - 2025: Lower back reconstruction with free ALT flap, free radial bridge flap and vein graft

Andrea Donfrancesco

A challenging case of midline mid-lower back defect is presented. The patient underwent previously vertebral chondrosarcoma resection, spine fixation and post-operative radiotherapy, and was re-operated 2 years after because of vertebral bone re-absorption and rupture of the previously done spinal fixation. The skin and soft tissue never healed and the patient had a 22 x 10 cm defect of the mid-lower back with exposed fixation material, exposed dura above the spinal cord, and radiotherapy damaged tissue around. No local reconstructive option was feasible. We reconstructed the defect with a free ALT, connected to a free radial bridge flap and a saphenous vein graft, hooked up to the thoracodorsal vessel, and a new spinal fixation was performed. Reconstruction was successful.

Case 1 (2023): Left Cheek Reconstruction with Combined VY- and Transposition Flap

Harald Welling, Michael Rose

Case 02 2026: Tarsoconjuctival Flap for Eyelid Reconstruction

Ajla Sabitovic, Rikke Børthy Petersen, Nanja Gotland Sundstrup

This case describes the use of a tarsoconjuctival flap for reconstruction of the lower eyelid following excision of a basal cell carcinoma in a 76-year-old woman. Due to the tumor size, depth and location near the limbus of the eye, direct closure was not possible. The tarsoconjuctival flap was chosen as the preferred reconstructive approach because of its ability to reconstruct all layers of the eyelid. Postoperative follow-up at six months demonstrated satisfactory aesthetic and functional outcomes.

Case 2 - 2025: Reconstruction of an extensive foot defect using a combined sensory split latissimus dorsi and serratus anterior muscle flap

Luisa Lotter, Ilja Käch, Volker Schmidt

A 67-year-old male patient sustained a complex foot injury with an open Lisfranc dislocation of the medial cuneiform bone and shaft fractures of the 2nd to 4th metatarsals in July 2024, as a result of a crush trauma. After initial osteosynthetic treatment, a pronounced necrosis developed in the area of the hindfoot and forefoot over time and an implant-associated wound infection. The patient was then transferred to our tertiary care hospital for specialized defect reconstruction. At first radical necrosectomy was performed, resulting in a 10 x 12 cm soft-tissue defect in the heel area, which extended medially and laterally. In the area of the forefoot, there was also a full-thickness wound measuring 4 x 3 cm with exposed osteosynthetic material, bone, and tendon.

Case 2 (2024): Perforator-based soft tissue reconstruction around the knee, utilizing a D-POP ALT flap

Abdullah Najib Maalouf, Peter Sinkjær Kenney

Case 2 (2023): Brystrekonstruktion med breast sharing-teknik

Nanja Gotland, Charlotte Uth, Alessandro Venzo

Case 6: Fingertip reconstruction by a V-Y flap and eponychial flap in a patient with fingertip amputation

Alina Strohmaier, Martina Greminger

A 58-year-old male presented with fingertip amputation of the left index finger after a bicycle accident. The injury was classified as Ishikawa Zone 2/Allen Type III, with ulnar oblique pulp defect, subtotal nail bed loss but with intact germinative matrix, and exposed bone. Treatment involved a volar V-Y advancement flap for soft tissue coverage and an eponychial flap to allow visible nail growth. Postoperatively, early mobilization was conducted. At 6-month follow-up, the patient reported good functional outcomes. Examination revealed adequate soft tissue coverage, a normally growing but short nail without a claw-nail deformity, and a stable fingertip. The patient was able to play the piano again. A near-complete range of motion and normal sensation were achieved. This case demonstrates successful fingertip reconstruction using local flaps to restore function and maintain the nail, even when the nail bed is almost completely injured.

Case 16 2026: Severe Foot Degloving Injury Following a Forklift Crush: A Limb-Salvage Case

Cecilie Jansen, Emil Villiam Holm-Rasmussen, Mette Stueland Wolthers

A 30-year-old previously healthy man was admitted to The Trauma Centre at Copenhagen University Hospital, Rigshospitalet after his left foot was crushed by a 1.5-ton forklift at work. He sustained a large open fracture and an extensive circumferential degloving injury involving the foot and ankle, while distal perfusion remained intact. Computed Tomography (CT) demonstrated multiple intra-articular fractures with suspected Lisfranc injury and no vascular injury on CT angiography. Following orthopedic stabilization, plastic surgical management focused on debridement, tissue viability assessment, skin and heel-pad preservation, and limb salvage. This case highlights the challenges of severe foot degloving and multidisciplinary limb-salvage management.

Case 17: Immediate Proximal Row Carpectomy for combined Scaphoid and Lunate Dislocation Without Fracture

Jorge Jimenez Lopez, Anastasia Boptsi, Konstantinos Kalousis

Carpal dislocation fractures are uncommon injuries, most frequently associated with high-energy trauma. Combined carpal dislocations without associated bone fractures are even rarer. Delayed treatment can have serious consequences. The case presented here involves an 86-year-old man with dislocation of the scaphoid and lunate bones, as well as acute carpal tunnel syndrome resulting from the injury. PRC is mostly a salvage operation but given the severity of ligamentous disruption, the need to restore the patient's mobility and also the fact, that scaphoid was irreducible, a proximal row carpectomy (PRC) was performed to preserve wrist range of motion (ROM).