Modified dorsalis pedis flap for coverage of a pretibial pressure sore after hip rotationplasty

A pretibial pressure ulcer after hip rotationplasty was reconstructed with a modified dorsalis pedis islandflap. Total femur resection and replantation of the lower leg to the hip joint had been previously performed for recurrent synovial sarcoma. A pretibial pressure sore developed during subsequent plaster-cast immobilisation. After excision of the ulcer, the defect measured 18×4 cm. The anterior tibial vessels were dissected to serve as a vascular pedicle for the dorsalis pedis fasciocutaneous flap. The reconstructed skin covering the tibial bone enabled the patient to walk on a prosthesis.