Advances made in microsurgical techniques have dramatically improved the treatment of complex limb injuries, such as a closed fracture covered by healthy tissue and a complex open fracture of the tibia. Microvascular transfers from the foot have revolutionized the treatment of digital amputations, and vascularized bone transfers are used in various indications. The microvascular techniques are still evolving. Many imaginative flaps are being proposed to meet precisely the functional requirements of the various defects. Alternative anastomotic techniques are being investigated and the no-flow...