Abstract
Summary. Tissue defects of the anterior surface of the lower leg and the knee joint is a severe problem at the treatment of orthopedic patients.
 Objective. Analysis of the results of using the medial gastrocnemius flap (MGF) in orthopedic patients; highlighting peculiarities of surgical technique.
 Materials and Methods. 8 patients (10 cases) who underwent the transposition of the MGF. The age of the patients was 19–74 years (on average 40.5±5.7 years); there were 6 males and 2 females. The list of cases: open fractures – 2 cases, combat injury – 2 patients (3 cases), skin necrosis after osteosynthesis – 3 patients (4 cases), and skin necrosis after total knee replacement – 1 case. The results of treatment were assessed in terms 9 months – 10 years by the Lysholm scale.
 Results. Autodermoplasty during MGF transposition was performed in two cases and after a few days in others. In cases with open fractures, the osteosynthesis and external fixators reassembly were done; conversion of osteosynthesis was performed one month after autodermoplasty. In cases of skin necrosis after osteosynthesis and total arthroplasty, the implants were never removed. Knee function according to the Lysholm scale ranged from 70 to 100 points (mean 88.2±3.3).
 Conclusions. The transposition of the MGF for the replacement of tissue defects of the anterior surface of the lower leg and knee joint is an effective method in orthopedic surgery, which helps to solve the problem of infectious complications and to save the supporting-kinematic function of the lower extremity.
Highlights
The anterior surface of the upper third of the tibia and knee joint is covered with inelastic skin and a thin subcutaneous tissue, which are close to the underlying bone
Autodermoplasty during medial gastrocnemius flap (MGF) transposition was performed in two cases, and a few days after the surgery in others
In cases of combat trauma, the MGF transposition was combined with the external fixator reassembly to free the knee joint
Summary
The anterior surface of the upper third of the tibia and knee joint is covered with inelastic skin and a thin subcutaneous tissue, which are close to the underlying bone. Tissue defects in this area occur due to various reasons: trauma, complications during arthroplasty, treatment of tumors, etc. [1] established the anatomical possibilities of using the medial head of m.gastrocnemius as an island flap for covering tissue defects of the anterior surface of the upper third of the lower leg, this surgical technique is successfully used in traumatological and oncological cases [2,3,4]. Significant advantages of the medial head of m.gastrocnemius (medial gastrocnemius flap – MGF) are permanent vascular anatomy, simple elevating technique, mobility, and minimal loss of the donor site [5].
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