Medial Hemisoleus Flap for Middle Third of the Tibia Defects

Covering soft tissue defects of the tibia is challenging, especially in the presence of underlying osseous trauma. The soleus muscle flap remains the treatment of choice for soft tissue defects in the middle third of the tibia. The flap is reliable and requires a relatively short operative time while maintaining minimal donor site morbidity. However, when the muscle flap is performed without a modified fasciocutaneous composite, it requires a split-thickness skin graft. Muscle flaps have the additional advantage of improving vascularity and fighting infection.

Anterolateral adipofascial turnover flap of the leg: Anatomical study

AIM

The aim of this study is to clearly define the vascularisation of the lateral paratibial septum of the leg, defining the basis for a vertical pedicled adipofascial flap harvested from the anterolateral aspect of the leg to cover pretibial soft tissue defects.

MATERIALS AND METHODS

Twelve cadaver legs (eight fixed with formalin and four fresh) were dissected. The vessels running into the lateral paratibial septum were identified. The number of vessels were noted and evaluated at the lateral border of the proximal, middle and distal thirds of the leg. In addition, an angiographic study was performed on two limbs to confirm the connection between tibialis anterior artery and the overlaying fascia through these septal vessels.

RESULTS

All the specimens had periosteo-septal vessels running in the lateral aspect of the tibia. The average number was 6.6. The distribution was constant in all the thirds of the leg.

CONCLUSION

These data are useful to propose the harvesting technique for adipofascial flap with vertical pedicle as a suitable reconstructive option to cover pretibial soft tissue defects.