Answer:
This paper, "Free microvascular muscle flaps with skin graft reconstruction of extensive defects of the foot: a clinical and gait analysis study," reviews the outcomes of 18 patients treated at the MGH over a 5-year period with foot defects treated with free flaps. The authors conclude that “free muscle transfer with skin graft coverage can be a successful form of reconstruction for traumatic defects of the foot and ankle region in well-selected patients who have overall normal foot innervation and deep pressure sensibility. Useful when there are 1) Large defects, 2) Anterior defects, 3) Where sacrifice of local tissue is not desirable, 4) regions where local tissues and/or vessels are damaged, 5) Three-dimensional defects where dead space exists after bony debridement, and 6) Failed local flaps.