ABSTRACT
This chapter discusses the management of soft-tissue injuries of the lower extremity with particular emphasis on reconstruction in the upper and middle third leg wounds. Soft-tissue reconstruction of the lower extremity following trauma can be extremely challenging and complex. A key concept of soft-tissue reconstruction of the lower extremity is to ensure adequate debridement and irrigation of the wound. The ideal time for soft-tissue reconstruction in lower extremity trauma is somewhat controversial. The mainstay of reconstruction of proximal and middle third defects of the lower extremity has been reconstruction with muscle flaps. The vastus medialis originates from the distal half of the intertrochanteric line, medial lip of the linea aspera, medial proximal supracondylar line, tendons of the adductor longus and adductor magnus muscles, and the medial intermuscular septum. Proximally the muscle heads are fused, but distally there is a septum dividing them.
