In certain cases of lower limb problems, the combined approach of Plastic and Orthopedic surgeons offers specific advantages. One stage operation, quicker recovery, less hospital stay and reduced cost is some to mention. We present our experience including both chronic and emergency cases that we applied the combined approach. The use of muscle flaps mainly, provided smooth postoperative course especially in patients that were at increased risk of skin necrosis due to previous operation scars or infection.

Using this approach cases such as revision knee arthroplasty or trauma had much better results

The preoperative recognition of this particular group of patients at increased risk and the planned combined intraoperative approach are the most important steps in order to avoid complications. Our choices were pedicle and free muscle flaps. We present our experience in treating patients following this regime with encouraging results overall