{
  "abstract": "Background: Free tissue transfer is central to reconstruction of Gustilo IIIC lower-extremity injuries, but recipient vessel selection is challenging when local vasculature is compromised. We describe two Gustilo IIIC injuries reconstructed using thigh-based recipient vessels. Case Presentations: Case 1: A 50-year-old man sustained an open tibial fracture with popliteal artery thrombosis and extensive tibial vessel injury. Following revascularization and serial debridement, a 25 × 15 cm tibial defect was reconstructed with a contralateral anterolateral thigh (ALT) free flap to the descending genicular artery (DGA), using an interposition great saphenous vein graft. The flap survived without complication. Case 2: A 35-year-old man sustained an open tibial fracture with complete popliteal artery transection requiring vascular reconstruction. A 20 × 14 cm defect was initially reconstructed with a free latissimus dorsi flap to the DGA using an interposition vein graft, complicated by venous thrombosis and flap loss. Subsequent reconstruction with an ALT flap and radial forearm flow-through flap to the superficial femoral vessels (SFA) achieved successful soft-tissue coverage. Discussion: The DGA provides an accessible recipient outside the primary zone of injury, with consistent anatomy and suitable calibre for microsurgical anastomosis. Its location facilitates a two-team approach, avoids popliteal fossa exploration, and may reduce interference with subsequent skeletal procedures. The SFA is a valuable alternative recipient vessel, offering robust and reliable inflow with a good arterial pressure head. Conclusion: Thigh-based recipient vessels, particularly the DGA and SFA, should be considered in severe lower-limb trauma when conventional below-knee recipient vessels are unavailable or compromised.",
  "abstract_shown": true,
  "affiliations": [
    "Corresponding author.",
    "Plastics, Reconstructive and Aesthetics Surgery Service, Department of General Surgery, Khoo Teck Puat Hospital, Singapore"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Faith Ai Ping Zeng"
    },
    {
      "affs": [
        1
      ],
      "name": "Sally Shin Jie Chan"
    },
    {
      "affs": [
        1
      ],
      "name": "Yijun Wu"
    },
    {
      "affs": [
        1
      ],
      "name": "Jolie Jingyi Hwee"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/01htgznm9ynct.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jpra.2026.09.033",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2352587826003499",
  "id": "01htgznm9ynct",
  "issns": [
    "2352-5878"
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  "landing_url": "https://doi.org/10.1016/j.jpra.2026.09.033",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
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  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
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      "lcc",
      "RD1-811"
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      "openalex",
      "2746|Reconstructive Surgery and Microvascular Techniques"
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  "pdf_url": "https://www.jprasopen.com/article/S2352-5878(26)00349-9/pdf",
  "pmcid": "PMC13715301",
  "pmid": "42953271",
  "published": "2026-09-30",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/01htgznm9ynct.ris",
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    {
      "first_seen": "2026-10-30T13:43:45Z",
      "native_id": "ff6356fd79234814b917fb401c5b949b",
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      "url": "https://doi.org/10.1016/j.jpra.2026.09.033"
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    {
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      "url": "https://europepmc.org/article/MED/42953271"
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    {
      "first_seen": "2026-11-01T12:22:38Z",
      "native_id": "PMC13715301",
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      "url": "https://doi.org/10.1016/j.jpra.2026.09.033"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Reconstructive Surgery and Microvascular Techniques",
      "subfield": "surgery"
    }
  ],
  "title": "Use of thigh-based recipient vessels for free flap reconstruction in gustilo anderson type IIIC lower extremity open fractures: Description of two cases",
  "title_text": "Use of thigh-based recipient vessels for free flap reconstruction in gustilo anderson type IIIC lower extremity open fractures: Description of two cases",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:22:38Z",
  "url": "https://research.draconitic.com/paper/01htgznm9ynct",
  "venue": "JPRAS Open",
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}