PMC4878253_01
Medial and lateral malleolar defect
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F1
A 14-year-old boy presented to us with a 2 weeks old infected bimalleolar defect with dimensions of 12 cm x 7 cm medially and 8 cm x 4 cm laterally [Figure 1] at the ankle.
Chimeric anterolateral thigh and anteromedial thigh flaps
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F2
Considering the dimensions and proximity of the two defects, a chimeric fasciocutanous anteromedial thigh (AMT) and anterolateral thigh (ALT) flap [Figure 2] based on the lateral circumflex, femoral vessels was planned and their perforators marked with hand held Doppler.
Settled anterolateral thigh and anteromedial thigh flaps
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F3
Both the flaps survived without any complications [Figure 3].
X-ray showing post arthritic sequele
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F4
At 11 months follow-up, the patient is ambulatory with a stiff ankle in slight varus position with X-ray showing extensive post-septic arthritic sequale of the ankle joint [Figure 4].