Lateral Gastrocnemius Flap Cover for Distal Thigh Soft Tissue Loss

Abstract

The gastrocnemius muscle flap has been used extensively for cover around the knee. However, the use of the lateral gastrocnemius for cover of the distal thigh has not been well described. The lateral gastrocnemius flap was used in eight patients from October 2004 to February 2009 for cover of the distal thigh proximal to the knee joint. We included patients who had soft tissue loss secondary to trauma and infection and who required soft tissue cover in the distal lateral thigh (>8 cm proximal to the joint line). The average age of the patients was 40 years (21-64 years). Four patients had soft tissue loss secondary to trauma, two had loss secondary to chronic infection, and two patients had soft tissue loss after surgical infection. All patients had resolution of infection at final follow-up. The average area of soft tissue cover achieved was 14 × 9 cm. The maximal proximal extent reached with lateral gastrocnemius flap from the joint line was 17 cm (8-17 cm) measured in full knee extension. There were two complications. One patient developed a common peroneal palsy and infection, which recovered after re-exploration. Another patient developed a sinus, which resolved after removal of a loose screw. The lateral gastrocnemius muscle flap is effective in the cover of the lateral distal thigh.