Fifteen lower extremities with large traumatic defects in the soft
tissues were resurfaced by free microvascular transfer of the latissimus
dorsi muscle and overlying skin. This procedure was particularly useful in
four patients in whom a portion of the extremity had been acutely denuded
of its soft-tissue sleeve, leaving exposed bone, joint, or tendon. It was
also effective in eleven patients with chronic lesions who required
additional reconstructive procedures (arthrodesis, internal fixation,
bone-grafting, or tendon-grafting), and in the treatment of chronic
osteomyelitis when infected bone and soft tissue had to be liberally
debrided. In the eleven patients who had chronic osteomyelitis at the time
of the transfer (five with infected, unstable tibial fractures), no
subsequent drainage was evident at an average of twenty-two months'
follow-up.