case_images: PMC10283432_01
case_images: Appearance (A) and plain radiograph (B) of the left foot on Arrival at the trauma center.
case_images: ICRP_A_2225610_F0001_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0001_C.jpg
case_images: F0001
case_images: Plain radiography revealed a proximal phalanx fracture of the big toe and 2nd to 5th metatarsal fractures (Figure 1).
case_images: Appearance (A) and plain radiograph (B) of the left foot after Emergency operation.
case_images: ICRP_A_2225610_F0002_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0002_C.jpg
case_images: F0002
case_images: Negative pressure wound therapy was performed for the skin defect (Figure 2).
case_images: Elevation of the RSAF. (A) The flap after elevation. (B) The proximal pedicle included an artery, two veins, and a nerve.
case_images: ICRP_A_2225610_F0003_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0003_C.jpg
case_images: F0003
case_images: The operation was terminated by rough suturing around the skin flap without any intervention on the vessels (Figure 3).
case_images: Clinical course throughout the 3 d after flap elevation. (A) The proximal pedicle was clamped with a vascular clip. (B) After 3 h, the flap was clearly congested. (C) Immediately after removing clips, the color tone of the flap normalized.
case_images: ICRP_A_2225610_F0004_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0004_C.jpg
case_images: F0004
case_images: Immediately after removing the clips, the color tone of the flap normalized (Figure 4).
case_images: Clinical course throughout the 5 d after flap elevation. (A) Each of the three vessels in the proximal vascular pedicle was clamped with a separate vascular clip. (B) After 6 h, the flap was clearly congested. (C) Immediately after removing the clips, the color tone of the flap normalized.
case_images: ICRP_A_2225610_F0005_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0005_C.jpg
case_images: F0005
case_images: Immediately after removing the clips, the color tone of the flap normalized (Figure 5).
case_images: Clinical course throughout the 7 d after flap elevation. (A) The remaining superficial sural vein was clamped with a vascular clip. (B) After 6 h, the flap was clearly congested.
case_images: ICRP_A_2225610_F0006_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0006_C.jpg
case_images: F0006
case_images: Immediately after removing the clip, the color tone of the flap normalized (Figure 6).
case_images: Clinical course throughout the 10 d after flap elevation. (A) The superficial sural vein was clamped with a vascular clip. (B) The flap did not become congested, even after 6 h.
case_images: ICRP_A_2225610_F0007_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0007_C.jpg
case_images: F0007
case_images: The flap did not become congested even after six hours, and clamping was continued (Figure 7).
case_images: Clinical course throughout the 12 d after flap elevation. (A) The superficial sural vein was thrombosed distal to the vascular clip. (B) The superficial sural vein was dissected and the flap transferred. (C) The color of the flap remained normal after surgery.
case_images: ICRP_A_2225610_F0008_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0008_C.jpg
case_images: F0008
case_images: The color of the flap remained normal after surgery (Figure 8).
case_images: Clinical course after flap transfer. (A) The flap survived without necrosis. (B) A full thickness skin graft was performed. (C) The soft tissue healed completely 2 months after the injury.
case_images: ICRP_A_2225610_F0009_C.jpg
case_images: PMC10283432_01_ICRP_A_2225610_F0009_C.jpg
case_images: F0009
case_images: Ointment treatment was continued, and the soft tissue healed completely two months after the injury (Figure 9).