Case 24 2026: Ipsilateral Myocutaneous Latissimus Dorsi Flap for Traumatic Upper Limb Soft Tissue and Vascular Injury Following Road Traffic Accident

Keywords: Latissimus dorsi flap, upper limb trauma, soft tissue reconstruction, vascular injury, degloving injury Authors: Sumaira Sattar, FCPS (Plastic Surgery), Institution: SMBB Institute of Trauma, Karachi, Pakistan Abstract A 20-year-old female presented with a severe traumatic injury to the right upper limb following a road traffic accident involving a pedestrian–motorbike collision with subsequent run-over injury. The trauma resulted in extensive soft tissue loss, degloving injury, and associated vascular compromise. Initial management followed advanced trauma protocols, after which the patient was referred for vascular and reconstructive assessment. Imaging revealed brachial artery thrombosis with segmental radial artery injury; however, hand perfusion was maintained through collateral circulation. Following stabilization and vascular reconstruction using a reverse great saphenous vein graft, soft tissue coverage was achieved with an ipsilateral myocutaneous latissimus dorsi flapThe flap provided durable coverage of exposed vital structures and the elbow joint without the need for microsurgical anastomosis. At three-month follow-up, the patient demonstrated excellent functional recovery with satisfactory aesthetic outcome. This case highlights the reliability of the latissimus dorsi flap in complex traumatic upper limb reconstruction. Patient medical history A 20-year-old unmarried female, with no known comorbidities, presented to the emergency department five hours after a road traffic accident involving a bike-versus-pedestrian collision. Following the initial fall, the patient sustained a secondary run-over injury to the right upper limb. There was no history of loss of consciousness, head injury, or trauma to other body regions. Initial assessment and stabilization were performed according to trauma protocols, following which the patient was referred to the plastic and vascular surgery teams for definitive management of the limb injury. Before and After