Free composite latissimus dorsi muscle-rib flap not containing the intercostal artery and vein for reconstruction of bone and soft-tissue defects.

Reconstruction of bone and soft-tissue defects of the forehead and leg was done with use of a free latissimus dorsi muscle-rib flap. By utilizing the curve characteristic of the rib and by filling the cavity with latissimus dorsi muscle, the forehead could be restored in a good shape. In our application of this flap to the leg, it is considered in retrospect that reconstruction with the use of two ribs should have been done. Furthermore, it was concluded that in comparison with the heretofore employed vascularized rib graft, the scope of operative invasion is small in the use of this flap with hardly any risk of thoracostomy.