ABSTRACT
Fraturas expostas com grandes perdas cutâneas e osteomielite crônica de membros inferiores são problemas de difícil resolução para os cirurgiões plásticos, especialmente se localizados no terço inferior da perna ou no pé. Microcirurgia é uma técnica que fornece boa cobertura e aumento do aporte vascular para a região do trauma.
Introduction: open fractures and chronicosteomyelites in lower limb are really difficult problems for reconstructive surgeons, especially if it's localized on the lower third of the leg or in the foot. Microsurgery is a technique that can provide good soft tissue covering and increasing of blood flow for the trauma area. Method: we have studied 18 patients that were submitted to microsurgical flaps of latissimus dorsi and gracilis, depending of the size of defect, with open fractures IIIB and 5 cases with chronic osteomyelites. Results: between 18 cases, we had one total necrosis of the flap resulting from venous thrombosis. All of flaps have survived well. Conclusion: we have used microsurgical muscle flaps (latissimus dorsi and gracilis muscle) because they can provide good soft tissue covering, improvement of blood flow and they are easier to harvest if compared with perforator flaps. So, muscle flaps represents good alternatives for lower limb reconstruction.