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The use of a free compound rib-latissimus dorsi osteomusculocutaneous flap is described, for reconstruction of the tibia and soft tissue of the leg. The entire flap depends on the thoracodorsal artery for its blood supply. Dye injection studies of the artery demonstrated continuity between it and the intercostal artery, which is the periosteal vessel of the rib, through a dense network of vascular communications. The longest follow-up reported is three years and ten months. Follow-up showed that the use of this compound flap produced uniformly well-contoured soft tissue coverage and bony structure that thickened almost to the same dimensions as the tibia. The transferred tissue was examined by x-ray and bone scintigraphy, and was found to be viable.

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