15 latissimus dorsi free flap transfers were performed at the University of Ioannina Medical School during a 3-year period. Soft tissue defects in the upper (3) and lower (12) extremities resulting from trauma, septic pseudoarthrosis, osteomyelitis, open type IIIb fractures, incomplete amputations and tumor or unstable scar resection were covered by myocutaneous flaps in 6 cases and muscle flaps with split thickness skin grafts in 9 cases. Complications included pressure ulcer, infection hematoma and massive lung embolism. The results of the present study in which 13 of the 15 flaps were successful, suggest that an "orthoplastic" approach in covering soft tissue defects is beneficial.