This article reports our experiences treating soft tissue and bone def
ects in the lower extremity with free flaps. One of the most common ca
uses for lower extremity wounds are high-energy injuries. These kinds
of injuries contain soft tissue and bone defects beyond neurovascular
complications. The rate of infection and nonunion is very high in thes
e injuries. Between 1988 and 1996, we applied 33 flaps to 28 patients.
The numbers and kinds of the free flaps are as follows: 12 latissimus
dorsi, nine radial forearm, seven lateral arm, three vascularised fib
ula grafts with skin, one gracilis, and one medial plantar flap. Three
free flaps were lost (12%). The success rate is 88%. The advantage of
free flaps is that they allow the reconstruction of the large defects
in one-session operations. Thus, they decrease the rate of infection
and increase that of nonunion. The patient returns to his active life
at an earlier stage. (C) 1998 Wiley-Liss, Inc.