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Ten patients who sustained severe combined tissue injuries of the foot requiring reconstruction with composite free flaps were studied with a mean follow\u2010up of 3.4 years. A thorough clinical examination was performed, and gait analysis was carried out with kinetic and kinematic parameters. Bone integration and healing was observed with satisfactory foot morphology. All the patients returned to normal activities, although biomechanical gait analysis showed some functional disorders mainly in joint angular kinematics. Our results showed that microvascular flaps afford successful combined tissue reconstruction of the foot. \u00a9 2011 Wiley\u2010Liss, Inc. 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