Introduction: The Cobra Flap is the longest flap on the body. We present the first case report of a triple conjoined free flap that was able to cover the entire contralateral pelvis.

Materials and Methods: We presented a patient who sustained injuries to their left pelvis and left lower extremities, which consequently received a left hemipelvectomy. The surgical intervention involved the use of a triple conjoined free flap (Right Scapular Flap + Right Latissimus Dorsi Myocutaneous Flap + Groin Flap), which was able to cover the entire contralateral pelvis. The distal part of the flap was based on the subscapular artery and vein, which were anastomosed with the right medial circumflex femoral artery and greater saphenous vein.

Discussion and Conclusions: The flap was able to provide adequate coverage and blood supply to the affected area. The advantage of this triple conjoined flap is the possibility to cover long defects without adding a third vascular anastomosis. Moreover, the donor site of the conjoined scapular–LD–groin flap is closed primarily and does not require skin graft. The principal disadvantage of the triple combined flap is the necessity to change position of the patient during the operation because the groin and dorsal areas are not accessible at the same time. The triple conjoined flap can be considered a safe and useful reconstructive tool in severe injuries of the lower limb, allowing for coverage of a large surface area with a single operation without increasing donor site morbidity.