Medical head of the gastrocnemius muscle with adipofascial extension flap for tibial bone coverage

ABSTRACT

The gastrocnemius muscle remains the workhorse for providing soft tissue over the knee and upper tibia. Other local flaps were described to be used as an alternative to the gastrocnemius muscle as for example the posterior fasciocutaneous flap and saphenous flap. In this study, ten cases of defects located along the upper two thirds of the tibia which were covered using the medial head of gastrocnemius muscle with adipofascial extension flap were described. Nine flaps survived completely and one flap had marginal loss of 1cm. it was noticed that an adipofascial extension up to 12 x 6 cm can be elevated simply, survives in most of the cases and enable the surgeon to cover the whole length of the upper two thirds of the tibia. Also, it can be used in cases of scarred leg skin, it preserves normal leg skin, it is easy to perform subsequent orthopaedic work underneath and effective in the treatment of osteomyelitis