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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Objective The aim of this study was to evaluate coverage of middle third leg soft tissue defects using distally based hemigastrocnemius muscle flap regarding advantages, disadvantages, and rate of complications. Background Skin defects of the leg still present a reconstructive problem particularly if associated with complicated orthopedic lesions, which is why coverage of the soft tissue defects of the middle third leg is a challenge to plastic surgeons Patients and methods This study was done at the Department of Plastic and Reconstructive Surgery, Menoufia University Hospitals, from January 2015 to January 2017, with a follow-up period of 12 months. The study included 20 patients – 15 males and five females – and their ages ranged between 22 and 65 years. Patients presented with posttraumatic pretibial defects, and the main cause was motorcycle accidents. Some patients were associated with fracture of the tibia or both bones of the leg. All defects were covered by the distally based hemigastrocnemius muscle flap. Results Early complication included graft rejection in two (10%) patients, partial flap necrosis in two (10%) patients, wound infection in one (5%) patient, postoperative hematoma in one (5%) patient, and delayed graft take in one (5%) patient. Late results during follow-up showed one (5%) patient with hypertrophic scar of the donor area and one (5%) patient with hyperkeratosis. All postoperative complications were managed conservatively, and flap provided stable reconstructive option. Conclusion The distally based hemigastrocnemius muscle flap can be used for reconstruction of the middle third leg soft tissue defects.

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