External fixation and vascular damage: report of a case.

The case history is presented of a patient in whom the anterior tibial artery was clearly perforated by the distal pin of an external fixation device. This necessitated a dorsal pedis free flap instead of transposition of the flap to cover a degloved heel and sole. Review of the literature showed only a few case reports on vascular damage, suggesting that this complication is uncommon. In most cases, secondary erosion seems to be the cause, but as noticed by us direct arterial and/or venous damage is possible.