Abstract
The traditional pedicled gastrocnemius muscle flap has often been used to repair soft-tissue
defects caused by trauma. However, it is difficult to cover skin defects in the distal
third of the lower extremity because of its range of excursion. We have attempted
use of a free ipsilateral gastrocnemius muscle flap for coverage of skin defects in
the distal third of the lower extremity. In three patients with skin defects due to
Gustilo type III open fractures, a free gastrocnemius flap was used for coverage of
the same leg. The follow-up period ranged from 12 months to 2 years. Microsurgical
anastomosis of the vascular pedicle to the tibialis posterior vessels was performed
by end-to-side anastomosis proximally to the ankle. The postoperative course was uneventful
and showed stable coverage of the wound. All free flaps were successfully transferred,
and the defects healed primarily. Bone fusion in all of the patients in this series
progressed satisfactorily. This free muscle flap is useful for reconstruction of defects
in the distal third of the lower extremity in Gustilo III open fractures.
Keywords
gastrocnemius muscle - free ipsilateral muscle transfer - distal third lower extremity
