Effectiveness of the gastrocsoleous flap for coverage of soft tissue defects in leg with emphasis on the distal third

AUTHORS

Afshin Heshmati 1 , Amirreza Sadeghifar 1 , Aliya Ayatollahi Mousavi 2 , Vahid Hesami 3 , Alireza Saied 4 , *

AUTHORS INFORMATION

1 Assistant Professor Department of Orthopaedics, Medical Informatics Research Center, Kerman University of Medical Sciences, Kerman, Iran.

2 Orthopaedics Resident, Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran.

3 General Practitioner, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.

4 Associate Professor Department of Orthopaedics, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.

ARTICLE INFORMATION

Hormozgan Medical Journal: 17 (6); e88259
Published Online: September 09, 2012
Article Type: Research Article
Received: July 14, 2012
Accepted: September 09, 2012

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Abstract

Introduction: The standard methods for reconstruction of soft tissue defects in legs are
gastrocnemius flap for proximal third defects, soleus flap for middle third and free flap in
the distal third. However, there are problems with the use of free flap, like increased
operative time, damage of major vessels and the need for experienced microsurgeon. In this
study we examined the ability of the gastrocsoleous flap for coverage of leg soft tissue
defects.
Methods: This cross-sectional study was undertaken on 23 patients (20 male and 3 female)
with the mean age 32.13 years (14 to 65). This group consisted of all of the patients referred
to Dr Bahonar Hospital, Kerman with soft tissue defects between April 2011 and April
2012. They were given informed consent for participation in the study and treatment of the
defect with muscle flaps. 8 patients with proximal third defects were treated with were
treated with gastrocnemius flap, 4 with middle third defects with soleus flap and 3 with
reverse soleus flap and 8 with distal third defects with reverse soleus flap. The patients were
followed up for at least 1 year. Finally the results were analyzed by SPSS 16.
Results: The results for patients with soft tissue defect in proximal and middle third of leg
repair was successful. In 5 patients with soft tissue defect in distal third of leg, repair was
complete but, in 3 of them flap failure was seen. Overall success rate for reverse soleous
flap was 72.7%.
Conclusion: The success rate of the flap for the upper and lower thirds was similar to other
studies and seems that this is the standard method. In the upper half of distal third reverse
soleous flap was successful, but in the lower half of the leg it failed in all 3 cases and it
seems that preoperative investigations such as angiography must be performed before
embarking on such a procedure.

Keywords

Muscle Flap - Gastrocnemius - Soleus- Reconstruction

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