Monday, November 1, 2010

Soleus Flap for Middle Third Lower Extremity Wounds

The Soleus Flap is used for coverage of defects of the middle third of the lower extremity. High energy wounds to the lower extremity that cause exposure of the underlying bone and fracture are best treated with coverage with this muscle.

The soleus is easily harvested via a longitudinal incision along the medial aspect of the leg. The soleus can be disinserted from the achilles tendon leaving the function of the gastrocnemius intact.

To increase the surface area of the soleus, the muscle can be scored to expand across a greater surface area of the fracture or fill in a dead space.

The photograph below shows the more superfical gastrocnemius muscle which has been left intact to preserve ankle flexion.

The soleus muscle can then be skin grafted to provide coverage of the muscle.