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A retrospective review of 304 consecutive microvascular free flaps to the lower extremity was done to identify the patterns of usage, results, and problems. The most common indication (91%) was for the replacement of extensive tissue loss caused by motor-vehicle injuries. Most of the defects were below the mid-tibia (73%). The associated compound fractures were predominantly gradable as Gustilo type IIIb 2) salvage of many impending amputations; 3) better prosthetic stump reconstructions; 4) better esthetic results.
Khouri et al. (Tue,) studied this question.