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Abstract
Since 1974, 31 cases of soft tissue defects associated with osteomyelitis of the lower leg have been treated by free flap transfer and followed up for more than three years. Four patients developed recurrences. Two of them were reoperated on and healed well. One patient was reoperated on three times, but remained infected. One patient developed a fever, but improved after intravenous infusion of antibiotics. Of the eight patients who underwent vascularised muscle transfer to the dead space created by saucerisation of the osteomyelitis, none developed signs of recurrence. By contrast, the four patients who developed recurrences were those in whom the dead space could not be completely filled with the free flap. It therefore seems important that after saucerisation, well-vascularised soft tissue should be used to pack the dead space completely to prevent recurrence of the osteomyelitis.