Background  Thorough surgical debridement is the first step for the treatment of chronic traumatic osteomyelitis of lower limbs, and the management of dead space after debridement is the key point of the treatment of the infection.

  Objective  To evaluate the efficacy of pedicled muscle flaps for the reconstruction of chronic traumatic osteomyelitis of lower extremities.

  Methods  A retrospective review of 35 consecutive cases with chronic traumatic osteomyelitis of lower extremities who underwent reconstruction by local pedicled muscle flap operation in Beijing Jishuitan Hospital from January 2014 to January 2018 was conducted. All cases had undergone pedicled muscle flap operation and would repair. Data were retrospectively reviewed concerning characteristics of the patients, C-M classification of chronic osteomyelitis, etiological results, application of antibiotics, choice of muscle flap, ESR, CRP changers and the wound healing.

  Results  Of the 35 cases, there were 29 (82.86%) males and 6 (17.14%) females, with average age of 32.45±9.30 years (ranging from 21-54 years). All muscle flaps were survived and the wound healed completely within 4 weeks, including 24 cases achieved primary healing, and 11 cases healed within 1 month after dressing change. Six patients underwent internal fixation within 1 year after operation. No infection relapses were found during the follow-up period of 1-2 years.

  Conclusion  These results show that the local pedicled muscle flap can effectively fill the cavity of lower limb bone defect, cover the exposed bone, improve bone blood supply, and have a strong anti-infection ability against chronic osteomyelitis infection, which is a good choice for the dead space management of chronic osteomyelitis in lower extremity.