Advancements in lower extremity reconstruction have made free tissue transfer for open lower limb fractures the gold standard of care in many units.1–2 Decisions regarding the use of fasciocutaneous versus muscle flaps are both surgeon and patient dependent. Muscle flaps are specifically unsightly to patients in the early stages of their reconstruction. However, the free Gracilis flap is quick to raise, with predictable anatomy, minimal donor site morbidity and is the workhorse flap for lower extremity reconstruction in our unit.
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