Double free-flaps are necessary when tissue cover cannot be sufficed with a single flap. The other factors to be considered when using two free flaps for resurfacing of distal limb defects are the availability of more than one recipient vessel, the risk of distal limb ischaemia and the donor site morbidity of double flap harvest. If these factors are adequately addressed, double free-flaps can be safely executed for resurfacing distal limb defects with minimal morbidity. We report the simultaneous harvest and transfer of the anterolateral and anteromedial thigh flaps inset and vascularised as double free-flaps to resurface a large bimalleolar defect in a 14-year-old boy with no additional morbidity as compared to that of a single free tissue transfer.

No abstract

Ameloblastoma is a benign odontogenic tumor generally present in the jaw bone. The purpose of this study was to evaluate the clinicopathological profile, treatment and its outcome in a consecutive case series of 8 cases involving mandible and also other tumor like conditions of mandible mimicking ameloblastoma. A total of 10 patients were treated over period of 4 years, which were retrospectively reviewed in our institution. Imaging (CT scan) was done in all the cases and Biopsy was done in 9 cases. Of the 10 patients, 6 males and 4 females were identified. The average age was 25.1 years (range 7-46 years). Swelling in the region of mandible was the only complaint in all the patients. Segmental mandibulectomy was done with free fibular graft was done in 8 cases, Hemimandibulectomy without reconstruction was done in one case and reconstruction with titanium plate was done in another case. All patients underwent grossly complete surgical removal of the lesions, and no recurrence occurred during the follow-up period. The clinical profile and outcome may provide some insights into the differential diagnosis and clinical management. The best treatment option available is surgical excision with either autologous graft or prosthetic implant which can result in a good prognosis and cosmesis.