Soleus Muscle Flap Application for Reconstruction of the Middle Third of the Leg

Abstract

Introduction: Lower limb injuries are common in emergency rooms and surgery services. Many are extensive wounds and have complicated and extended treatment. A good option for reconstruction is the use of muscle flaps. Purpose: The aim of this study is to analyze a case series of wounds in the middle third of the leg, using soleus muscle flap for reconstruction and evaluating its effectiveness. Methods: Seven patients with wounds in the middle third of the leg were selected to demonstrate its reconstruction using soleus flap. The procedures occurred between 2015 and 2017. Results: In six cases, the cause of the injuries was trauma, with bone exposure in all of them. One patient had osteomyelitis as the cause of the lesion. Partial skin graft from the flap was performed after two weeks. There was one case of infection, with no necrosis of flaps or suture dehiscence, neither systemic complications. None of them needed new surgical intervention. All patients had good evolution. Conclusions: Soleus muscle flap is a reliable flap and it is valuable for closing the defects in the middle third of the leg.

Short and long-term follow-up results of soleus muscle rotation flap for coverage of soft tissue defects of proximal and middle leg

“…Bortolini and Fraga reported wound infection in one out of six cases. 5 In addition, no necrosis of flaps or suture dehiscence or systemic complications were observed. Hassanpour et al, observed partial flap necrosis in one out of 12 patients in a case series.…”

“…Due to its constant anatomy and ease of harvest, it is the workhorse flap for soft tissue defects in the middle third of the leg. 5 It is commonly used as a muscle only flap along with split-thickness skin graft (STSG), but it can be modified as a myocutaneous flap or segmental flap. The bony component can be added as required.…”