Use of Soleus Muscle Flaps for Coverage of Distal Third Tibial Defects

Kauffman, Christian A; Lahoda, L. U.; Cederna, Paul S.; Kuzon, William M.

doi:10.1055/s-2004-861516

Cited by 20 publications

(10 citation statements)

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“…The mean age in our study was 33 years old (15 to 65) conforming with the mean age incidence reported in literature by Rabbani et al, [16] with a mean of 30 (12 to 65), Fayman et al, [17] with a mean of 32 (22 to 57), with the mean age of 32 (14 to 65), Pu [14] with a mean age of 35 (12-52), Kauffman et al, [12] with a mean of 38 (18 to 61). However, others reported higher mean age as Sayed [18]with a mean of 46 (28 to 72),Schierle et al, [8] with a mean of 59 (34 to 78), Houdek et al, [19]with a mean of 67 (46 to 81).…”

Section: Discussionsupporting

confidence: 80%

“…The soleus muscle is frequently used as a local muscle flap for the reconstruction of defects of the middle third of the leg, based on its major pedicle. However, the viable use of the hemisoleus muscle in a reverse manner, based on its secondary distal pedicles, has been described by several authors for the reconstruction of defects of the lower third of the leg as an alternative to the microsurgical flaps [10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

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Reversed Hemisoleus Flap for Traumatic Wound Coverage in the Distal Third of the Leg

Younes¹,

Romeih

2019

The Medical Journal of Cairo University

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Background: Reconstruction of soft tissue defects of the distal third leg are common challenging therapeutic problems with significant long-term morbidity. Treatment options include cross leg flaps, local flaps (as muscle flaps and fasciocutaneous flaps) and the free vascularized flaps. Aim of Study:The aim of this study is to evaluate the clinical outcome of reversed hemisoleus muscle flap in coverage of traumatic soft tissue defects in the distal third of the leg. Patients and Methods:In this prospective study, we present 21 patients with traumatic soft tissue defects in the distal third leg with exposure of bone, tendons and neurovascular structures, managed by reversed medial hemisoleus muscle flap. Clinical and radiological data were analyzed.Results: The outcome of the flap surgery was evaluated after at least 6 months follow-up on the basis of flap survival, graft intake, functional gain and donor site morbidity [1] . Clinical results were graded as excellent, good, fair as follows: 13 showed excellent results (61.9%), 7 showed good survival (33.3%) and 1 flap was graded as fair (4.8%) with no poor results. The excellent and good results were considered as satisfactory results, while the unsatisfactory included the fair and the poor results. Accordingly, satisfactory results were found in 20 patients (95.2%), and the unsatisfactory results were found in 1 patient (4.8%) with reliable soft-tissue coverage and complete wound healing in all patients. Conclusion:This study shows that reversed medial hemisoleus muscle flap is a reliable reconstructive option for traumatic soft tissue defects on the medial side of the distal tibia in selected cases.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Reversed Hemisoleus Flap for Traumatic Wound Coverage in the Distal Third of the Leg

Younes¹,

Romeih

2019

The Medical Journal of Cairo University

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“…3 In the study of Kaukmann et al (2004) partial necrosis in one and flap failure in on patient (out of 12 patients), and that of Neale et al (1982) were 8 and 5 respectively (out of 71 patients). 18,19 In the study of Pu (2006), one patient developed flap necrosis (out of 14 patients) and was treated by debridement and flap advancement. Chittoria & Mishra (2000) reported 5% partial flap necrosis.…”

Section: Resultsmentioning

confidence: 99%

Soleus muscle flap for the coverage of pre-tibial defect of middle third of leg

Satter¹,

Khan

Awwal

2014

Bangladesh J Plastic Surg

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Soft tissue defects of the lower limb are a challenge to the plastic surgeon but a soleus muscle flap often provides the solution. Early reconstruction by soft tissue to cover exposed bone significantly reduces the risk of infection, nonunion and subsequent amputation. A Prospective, observational study was carried out in the Department of Plastic Surgery & Burn Unit, Dhaka Medical College Hospital and Department of Plastic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, from September 2011 to March 2013. 30 cases were selected by purposive continuous sampling who had soft tissue defect in front of the middle third of the legs only. Proximally based soleus muscle transposition flap was done by standard operative procedure under spinal anaesthesia or general anaesthesia and under tourniquet control. After 2 months of operation, final follow-up was done. Regarding the outcome of flap surgery, 18 (60%) cases were found excellent. 7 (23.33%) cases were good, 3 (10%) were fair and 2 (6.66%) were poor. In the final follow up, according to the preset criteria for evaluation of wound coverage by soleus muscle flap, the satisfactory result (excellent and good) was 83.33%. Unsatisfactory (fair and poor) result was in 16.67% cases. Effective coverage of pretibial defect of middle third of leg by soleus muscle flap with satisfactory outcome was seen in this study. DOI: http://dx.doi.org/10.3329/bdjps.v4i1.18685 Bangladesh Journal of Plastic Surgery January 2013, 4(1): 10-15

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“…5,6,9,10,14,15 A soleus muscle flap has frequently been selected more than any other local flaps for soft-tissue coverage of an open tibial wound in the distal third of the leg. 5,6,9,10,15,16 A medial hemisoleus muscle flap has served as a workhorse and been used successfully by the author for coverage of a less extensive tibial wound in the distal third of the leg. 5,9 Very often, when the size of a tibial wound is less than 50 cm 2 , a local flap, Reconstruction of a Tibial Wound in the Distal Leg such as a medial hemisoleus muscle flap, can be chosen primarily for soft-tissue coverage if the soleus muscle is not traumatized.…”

Section: Discussionmentioning

confidence: 99%

Soft-Tissue Reconstruction of an Open Tibial Wound in the Distal Third of the Leg

2007

Annals of Plastic Surgery

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Over the past 4 years, a total of 33 patients, each with an open tibial wound in the distal third of the leg, underwent a skin-grafted muscle flap reconstruction according to the new treatment algorithm developed by the author. When the size of the soft-tissue defect was less than 50 cm, a pedicled medial hemisoleus muscle flap was used for the soft-tissue coverage (n = 20). If the soleus muscle was traumatized, a small free muscle flap (ie, gracilis) was then used (n = 3). When the size of the soft-tissue defect was greater than 50 cm, a larger free muscle flap (ie, rectus abdominis or latissimus dorsi) was selected (n = 10). All patients were followed for up to 4 years. Three patients with a medial hemisoleus muscle flap developed insignificant distal flap necrosis and were treated subsequently with debridement and flap advancement. Five patients with a free muscle flap required an additional operation, and 2 patients had a subsequent debulking procedure of the flap for contour improvement of the leg. Reliable soft-tissue coverage with a well-healed tibial wound, evident fracture healing, and good contour of the leg were achieved in all 33 patients during follow-up. Following this new treatment algorithm, a selected option for an open tibial wound in the distal third of the leg can provide reliable soft-tissue coverage for different sizes of open tibial wounds and may offer a more cost-effective approach for managing such a complex clinical problem.

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Use of Soleus Muscle Flaps for Coverage of Distal Third Tibial Defects

Cited by 20 publications

References 10 publications

Reversed Hemisoleus Flap for Traumatic Wound Coverage in the Distal Third of the Leg

Reversed Hemisoleus Flap for Traumatic Wound Coverage in the Distal Third of the Leg

Soleus muscle flap for the coverage of pre-tibial defect of middle third of leg

Soft-Tissue Reconstruction of an Open Tibial Wound in the Distal Third of the Leg

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