Re-expansion edema is a rare, potentially life-threatening complication of the drainage of a spontaneous pneumothorax. With early recognition and timely treatment, complete resolution can be achieved. Risk factors include rapid re-expansion of the lung, young patient age, and a large pneumothorax persisting longer than 24 hours. If these risk factors are present, the chest tube should be inserted without primary suction. Doing so allows the lung to re-expand more slowly and may prevent this severe complication.

Local muscle flaps for covering pretibial defects have been widely replaced due to the establishment of microsurgical procedures. The intention of the following study is to examine the results of soft tissue covering using local muscle flaps and to find out if its application is still indicated. At our level 1 trauma center 21 patients with III B open tibial fractures were treated with a local muscle flap to repair the soft tissue injury in the proximal and medial part of the lower leg. At the late follow-up after the average of 29 months all soft tissue defects and fractures were healed. Except of slight swelling under full weight stress no obstruction of blood circulation could be verified. 14 patients rated their functional outcome as good to excellent. In view of our results we consider local muscle flaps a suitable alternative to the free myoplasty for situations in which a more elaborate surgery is not feasible in due time, e. g. patients with acute brain edema, organ failure or lack of compliance.