Over the period of three years 33 free latissimus dorsi-flaps and 23 pedicled myoplasties of various types for the coverage of large tissue and bone defects are performed. The operative technique of the free muscle transfer with microvascular anastomosis are described in detail. The postoperative management is outlined. The results of the free and pedicled muscle flaps are reported. In free transplantations the success-rate was 88% and in pedicled flaps 65% There is good evidence that bone consolidation and healing of the chronic bone infection can be improved by healthy vital soft tissue coverage. The indications for both procedures and the advantages and disadvantages of free and pedicled flaps are discussed.