Reconstruction of tissue defects in the distal lower extremities is challenging. The issue is further complicated when problems such as high-impact traumas, firearm injuries, and age-related arteriosclerosis are added to these factors. Patients who presented with open fracture of the lower extremity and underwent soft tissue reconstruction were analyzed The patients were evaluated in terms of age, sex, mechanism of trauma, wound coverage time, bone repair techniques, soft tissue repair techniques. Statistically, the time from initial injury to surgical reconstruction was compared according to location of injury, age, etiology stabilization technique. There were no statistically significant difference between the time from initial injury to surgical reconstructions according to the age, etiologies and stabilization technique; but distal region and bacterial contamination were found to have longer time from initial injury to surgical. Eleven patients (61.2%) underwent reconstruction using muscle flap. Not only the factors like the bacterial growth but also the level of the injury is also affected the time from initial injury to late surgical reconstruction. Cross-leg flaps can be used in selected patients to spare the extremity in patients with severe soft tissue and bone damage due to firearm injury, especially buckshot, when the recipient vessels are problematic.