A comparative study of free and pedicle flaps for lower extremity wounds.

Sixty-four flaps were used to treat wounds in 58 patients over a 5-year period. In this series there was a high incidence of healing of both tibial fractures and chronic osteomyelitis when covered with muscle. Better contour is achieved with muscle covered with meshed skin grafts than with musculocutaneous flaps. The survival rate for free flaps was 93% and for pedicle flaps, 100%. Complication rates were higher for pedicle flaps (45%) than for free flaps (30%), although major complications for free flaps (14%) were higher than for pedicled flaps (9%).