The results of 100 free microvascular transfers to the lower limb are presented. These show a high success rate with successful salvage of 95 limbs. The major complications were infection and delayed healing, osteomyelitis, and non-union. Early skin cover, within 14 days of injury, reduced the incidence of complications by half. Aggressive debridement and provision of early skin cover should be the aim of management of tibial trauma with tissue loss.