Reconstruction of traumatic transposition of the penis and scrotum and associated complex open abdominoperineal pelvic deformity with free innervated tensor fascia latae osteomyocutaneous flap.

Guidelines for the repair of full-thickness defects of the lower abdominal wall have been established. However, lower abdominal defects associated with traumatic bladder herniation and pubic symphyseal diastasis or bony loss have not been addressed. Poor abdominal wall contour, protuberance, and recurrent hernias are likely when there is discontinuity of the midline pelvis in association with full-thickness lower abdominal defects and visceral herniation. We devised an operation that would not only restore bony continuity by providing a vascularized bone flap but also simultaneously maintain the integrity of the attachment of the tensor fascia latae muscle to the iliac crest and reestablish musculofascial continuity.