Background/Objectives: High-energy trauma to the lower limb often results in extensive soft tissue loss with exposure of critical structures, posing a serious threat to limb viability. Early and effective coverage is crucial to prevent infection, promote bone healing, and preserve function. This report presents the use of a latissimus dorsi free flap for circumferential soft tissue reconstruction following a severe crush injury. Methods: We describe the case of a young female patient who sustained a high-energy crush trauma with a comminuted, displaced fracture of the middle and distal third of the tibia and complete circumferential soft tissue loss. Due to the extent and location of the defect, a latissimus dorsi free flap was selected for reconstruction. The surgical technique, microsurgical anastomosis, postoperative care, and rehabilitation protocol are detailed. Results: The latissimus dorsi flap provided reliable coverage of the entire defect, protected the underlying bone and hardware, and promoted wound healing. No major complications were observed. Functional recovery was satisfactory, with progressive weight-bearing and joint mobility achieved during follow-up. Conclusions: In complex lower limb injuries with extensive soft tissue damage, free flap transfer remains a key strategy for limb salvage. The latissimus dorsi flap, due to its size, reliability, and versatility, represents a valuable option for circumferential coverage and restoration of limb function following high-energy trauma.

Background: Demand for anesthesia-sparing body contouring techniques is rising. This study assessed the feasibility, safety, and outcomes of medial thigh lift performed exclusively under tumescent local anesthesia (TLA) in an outpatient setting. Methods: A retrospective review was conducted that included 43 female patients (mean age of 41.6 years; BMI of 27.6 kg/m²) treated from November 2019 to June 2023. All procedures used pure TLA without sedation; a horizontal excision alone or combined with liposuction was chosen according to preoperative evaluation. The end-points were operative time, intra-operative pain (four-point scale), complications, and 12-month patient satisfaction. Results: Surgery was completed under TLA in every case, with no conversion to general anesthesia. The median operative time was 30 min for excision-only procedures and 50 min when combined with liposuction. Intra-operative comfort was rated “excellent” (86.0%) or “good” (14.0%); no opioids were required postoperatively. The overall complication rate was 23.2% (10/43), limited to minor wound dehiscence (9.3%), dog-ear deformity (7.0%), and scar displacement/hypertrophy (7.0%). No seroma, hematoma, infection, thromboembolic events, sensory deficits, or hospital readmissions occurred. All patients were discharged after 4 h and resumed ambulation within 24 h. At 12 months, 97.7% reported being “very satisfied” or “satisfied.” Conclusions: Medial thigh lift under pure TLA provides reliable anesthesia and hemostasis, minimizes perioperative morbidity, and enables same-day discharge, with high patient satisfaction. The low incidence of only minor complications supports TLA as a safe, effective, and resource-efficient alternative to general anesthesia for selected patients with mild-to-moderate thigh laxity. Further comparative and long-term studies are warranted.