Comparative evaluation in the treatment of chronic post-traumatic osteomyelitis of the lower leg: free flaps compared with local flaps

Forty-nine out of 101 patients treated for post-traumatic chronic osteomyelitis of the lower leg at the Innsbruck University Hospital for Plastic and Reconstructive Surgery in Austria between 1979 and 1996 were included in this retrospective study. The following parameters were covered in the statistic evaluation: postoperative complications, rates of flap survival, recurrence and revision, nosocomial infections, duration of hospitalisation, chronic oedema of the lower leg, and patient satisfaction. Postoperative complications, recurrence, and flap loss rates were significantly lower in the free-flap group. These low rates are most likely responsible for the significantly shorter hospitalisation of patients treated with free flaps. For these reasons, their use may be considered first-choice therapy in the treatment of chronic post-traumatic osteomyelitis of the lower leg.