[Free flap-plasty in a larger soft tissue defect of the hip and gluteal region].
The purpose of this paper is to show a case in which we felt at the end, that the chosen procedure did not fulfill our expectations and in which an alternative procedure would have been preferable. In a 47 year old woman a deep, healed soft tissue defect between the left trochanter and the iliac crest was built up with a free latissimus dorsi musculocutaneous flap. The original plan was to suture the vessels to the gluteal vessels and the nerve to the gluteal nerve. The muscle would have been placed in such a way that the muscle fibres would run from the iliac crest to the trochanter to replace the lost gluteal muscle. This plan was proved on a cadaver dissection. In reality, however, the local vessels were not suitable in size. The flap vessels had to be attached directly to the femoral vessels in the groin area. The flap had, therefore, to be orientated in a different way. The final result gave an insufficient correction of the contour with no functional correction. It was felt in retrospect that contour correction without functional correction would probably have been better performed with an inferior rectus femoris musculocutaneous free flap.