Soft-tissue reconstruction of below-knee defects.

The stable closure of an indolent wound below the knee may require the placement of well vascularized flap tissue. Recent advancements in axial and microvascular flap transfer have nearly obviated the use of the cumbersome traditional cross-leg flap. Thirty-two flaps in 25 below-knee defects illustrate a variety of surgical options. Closed stable wounds were achieved in 24 of the 25 defects, and bony union was accomplished in 11 of 12 unhealed fractures.