Functional reconstruction of an extremity by free tissue transfer of the latissimus dorsi.

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.