Background: The goal of lower extremity reconstruction is the coverage of defects and open wounds of the leg to give patients a healed wound and to let them resume their life, ambulate, and go back to work while preventing amputation. Once the wound is clean and well-vascularized, a reconstructive option is chosen from the reconstructive ladder. Local flaps use tissue adjacent to the wound and regional flaps use tissue nearby in the leg based on a named or random blood supply. Local and regional flaps are useful to cover small to moderate defects in the leg and can cover bone or exposed vessels or tendons. Local and regional flaps can more easily cover defects of the proximal or middle third of the leg. Soleus muscle, being vascularized predominantly in its proximal regions, allow the rotation about the axis of the pedicle (good arc of rotation), without compromising vitality. It thus offers a good option for bone and soft tissue coverage of the proximal and middle thirds of the leg, being the most used, usually individually.
Aim: The aim is to study the different modalities of soleus muscle flap used in reconstruction of the mid third pretibial defects.
Patients and methods: This study includes a total of 20 patients with a clinical diagnosis of a defect on the anterior aspect of the lower limb with exposed tibial bone. Patients will have reconstruction of their middle third pretibial defects with soleus muscle flap. The procedures occurred between 2016 and 2018.
Results: 18 flaps survived completely with good color matching and needs split thickness graft 1-3 weeks later. In fifteen cases, the cause of the injuries was trauma, with bone exposure in all of them. Three patient had raw area due to orthopedic maneuver. One patient had diabetic wound and one with cellulitis with skin necrosis of the lesion. There was one case of bone sinus, with 2 cases of necrosis of flaps, no suture dehiscence or systemic complications.
Conclusion: soleus muscle flap offers a helpful solution in reconstruction of middle third tibial defect with minimal morbidity especially hemisoleus muscle flap
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