Latissimus dorsi myocutaneous free flap vascularised by an extra-anatomic graft in the lower limb following traumatic disruption of the popliteal artery.

A case is presented in which the thoracodorsal artery of a latissimus dorsi free flap was anastomosed to an autogenous reverse saphenous bypass graft. The bypass graft was used to revascularise a leg with traumatic disruption of the popliteal artery and an open comminuted fracture of the distal tibia and fibula with extensive soft tissue loss. At 2-year follow up, isotope scans showed patency of the extra-anatomic graft and a good flow into the thoracodorsal artery.