Repair of pretibial soft tissue defects in children with a medial hemisoleus pedicle muscle flap

Abstract

Objective To summarize our experience of repairing pretibial soft tissue defects in children with a medial hemisoleus pedicle muscle flap.Methods From October 2006 to October 2012,eight patients (6 boys,2 girls) at a mean of 7.5 years (range,4-12 years) with pretibial soft tissue defects underwent reconstruction with a medial hemisoleus pedicle muscle flap.All wounds were complicated with bone or tendon exposure,on the left side in 5 cases,and on the right side in 3 cases.Six cases had tibia fractures in the middle third part.The surface area of soft tissue defects ranged from 4.0 cm × 3.5 cm to 8.0 cm × 4.0 cm.The location of the wounds was on the middle and upper third of lower leg in 3 cases and middle in 5 cases.Four patients underwent emergency surgery and 4 patients received elective surgery.Immediate coverage of the defects with muscle flaps was performed by a meshed split-thickness skin graft.The donor site was closed directly.Results All flaps survived completely with satisfactory clinical results.The recipient area in one case had a small amount of exudate from drainage hole everyday,however,after removing the drainage strip,the wounds healed spontaneously with the help of dressing change for 2 weeks.Tibial fractures in six patients also healed after followed up for an average of 2.5 years (range,1.5 to 4 y).Conclusions The medial hemisoleus pedicle muscle flap is suitable for repairing of pretibial soft tissue defects in children because it has a constant vascular anastomy with highly vascularity,and is easy to harvest. Key words: Muscle flap; Pedicled tissue grafting; Soft tissue injuries