Double Island Latissimus Dorsi Muscle-Skin Flap for Through-and-Through Defects of the Forefoot

A case of osteomyelitis of the forefoot is presented. The defect was unusual in that both medial and lateral wounds were larger than the osseous tunnel that connected them. A double skin island latissimus dorsi vascularized flap utilizing larger skin islands than the diameter of the muscle pedicle perfusing them allowed for wound closure. The high density of musculocutaneous perforating vessels of this muscle-skin unit permit such a technique to be safe and effective.