Reconstruction of skin and soft-tissue defects in crush-injuries of the lower leg in children.

Severe crush injuries with open comminuted fractures of the lower extremity often result in extensive tissue loss. In such a situation early free microsurgical tissue transplantation offers most effective possibilities of treatment. Among others, two of the most eminent advantages of free microsurgical tissue transplantation are: 1. The possibility of tissue replacement which cannot be achieved by traditional procedures such as functional muscle transplantation or the replacement of extremely extensive tissue loss; moreover immediate or early bone coverage by well vascularized soft-tissue is most effective in the prevention of infection. 2. In many cases complete reconstruction can be achieved by a one-stage-procedure: this decreases the morbidity considerably. These advantages are demonstrated by clinical cases, where we used free microsurgical tissue transplantation.