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[Injuries with severe soft tissue damage. Osseous defects--septic complications; plastic surgery management to osseous reconstruction].

Most of the severe soft tissue problems following open or closed fractures can be treated successfully by means of local or microvascular muscle flaps. Thus open fractures can be changed to closed fractures, or cases of high grade osteomyelitis can be transformed into non-infected or low-grade infected ones as a prerequisite for successful internal fracture fixation or bony reconstruction. Follow-up of 319 muscle flaps shows a low flap loosening rate (4%) and low overall complication rate (8%). The results demonstrate the high value and benefit of soft tissue reconstruction in trauma and reconstructive surgery.