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

Abstract
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 cov-erage 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 neurovas-cular 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 cov-erage and complete wound healing in all patients.
Conclusion: This study shows that reversed medial hem-isoleus muscle flap is a reliable reconstructive option for traumatic soft tissue defects on the medial side of the distal tibia in selected cases.