PURPOSE: The distal lower extremity poses unique reconstructive challenges due to its requirements for durability of the loadbearing plantar surface and for thin, pliable contour in the dorsal foot and ankle region. The purpose of this study is to compare outcomes between muscle and fasciocutaneous flaps in patients undergoing free tissue transfer for foot and ankle wounds. METHODS: A retrospective review of 806 lower extremity free flap reconstructions (1979-2016) was performed. Soft tissue

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... e flaps used for traumatic injuries of the foot and ankle met inclusion criteria. Endpoints included takebacks, partial flap failure, total flap failure and wound complications. Defects were classified as those primarily involving the non-weightbearing surface (dorsal foot, ankle) vs. weight-bearing surface (plantar).