title: Microvascular free flaps in the treatment of defects of the lower legs.
abstract: Thirty-four microvascular free flaps were used to treat defects in the lower extremities after injuries. Twenty patients (74%) had severe open fractures (Gustilo type III B & C). Latissimus dorsi (n = 16) and iliac osteocutaneous (n = 7) flaps were most commonly used for coverage, and the overall failure rate was 9% (3/34). At follow up 29 of the patients (94%) had a reduced range of movement of the ankle, nine (29%) had some swelling and oedema, and 13 (42%) had occasional pain in the leg. Sixteen (52%) of the patients were limping, but 26 (84%) could walk one kilometre or more with no problems. No legs were amputated. The unemployment rate increased from 1/34 (3%) to 6/31 (19%) at follow up. Twenty-seven (87%) of our patients were satisfied with the results, despite the considerable and persistent limitation of function, and the increase in the unemployment rate.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Udesen
authors.forename: O C
authors.initials: OC
authors.lastname: Ovesen
authors.forename: I M
authors.initials: IM
authors.lastname: Nielsen
authors.forename: P E
authors.initials: PE
authors.lastname: Jensen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D005597:Fractures, Open / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D013524:Surgical Flaps; D016896:Treatment Outcome