Lower extremity fractures are very common, because of the complexity of lower extremity trauma and lower extremity anatomical peculiarities, often see the lower extremity fractures after surgery skin necrosis plate exposed patients, for orthopedic surgeons and patients, such cases are very difficult, the author engaged in orthopedic clinical work for more than 10 years, the use of microsurgery techniques to deal with many of these disorders, to avoid the risk of deepening infection leading to chronic osteomyelitis or even amputation. Such patients often have a long history, complex and diverse clinical manifestations, treatment means are also flexible and variable, the following combined with typical cases to make a brief introduction: Peking University Shenzhen Hospital hand, microsurgery Zhou hammer case 1 tibiofibular fracture in the external hospital tibiofibular plate internal fixation, 3 weeks postoperative tibial and inner ankle skin necrosis tibia and plate exposed remove the plate, external fixation frame fixed fracture free flap repair skin defects case 2 heel Skin necrosis 2 weeks after fracture heel bone and plate exposure designed calf flap transfer repair trauma Case 3 ankle fracture 2 weeks after surgery skin necrosis after debridement see tibia and plate exposure free flap transfer repair Case 4 fracture at the inner ankle 3 years after surgery, trauma does not heal, tibia exposure has been combined with chronic osteomyelitis after debridement huge trauma designed free flap repair trauma good recovery after surgery this type of disorder due to skin defects, artificial The patient is advised to consult a specialist in a timely manner to avoid serious consequences of prolonged or even spread of infection.