A case of distal-third reconstruction of a leg with bone exposure is r
eported, A rectus abdominis muscle free nap, based on the inferior epi
gastric artery, was anastomosed to the distal stump of the anterior ti
bial artery with reversed flow. This technique is suggested as an opti
on for microvascular reconstruction in the distal third of the leg. An
atomic and physiologic details are discussed.