Abstract
Background: Reconstruction of middle third soft tissue defects of the legs have been a challenge to the plastic surgeons. Patients and methods: We report 20 cases in which the extended single stage distally based sural flap was used to reconstruct soft tissue defects at the middle third of the leg over 2 year period. Result: Complications occurred in 4 patients (20%). Two patients suffered surgical site infections and another two experienced distal partial flap necrosis but all flaps survived. We can conclude that the flap is a good option for reconstruction of middle third leg defects of the leg. It has constant and reliable blood supply without sacrifice neither major vessel nor nerve
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