Microsurgical Reconstruction of the Lower Extremity in the Elderly.

Demand has increased for complex lower-extremity reconstruction in the steadily growing elderly patient group in many highly developed countries. Microsurgery is indispensable for soft tissue reconstruction and osseous consolidation salvaging leg function and preventing amputation, with its devastating consequences. Microvascular reconstruction can be performed successfully in specialized centers with low donor-site morbidity, minimal operative time, and comparably low complication rates. However, this requires thorough multidisciplinary planning, preoperative optimization of risk factors, such as diabetes and malnutrition, and individually adapted intraoperative management. Implementing these principles can reliably restore ambulation and mobility, maintaining autonomy in this population.