Matuszewski Paul E, Ulrich Gary L
Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky College of Medicine, Lexington, KY.
OTA Int. 2023 Jul 11;6(4 Suppl):e255. doi: 10.1097/OI9.0000000000000255. eCollection 2023 Jul.
Gastrocnemius and soleus flaps represent the workhorse local flaps to cover soft tissue defects of the proximal 1/3 and middle 1/3 of the leg, respectively. An important consideration before conducting a local flap is whether the flap can provide adequate coverage. The utility of the gastrocnemius flap can be increased using multiple techniques to increase the arc of rotation including the posterior midline approach, dissection at the pes anserinus and medial femoral condyle origin, scoring the fascia, and inclusion of a skin paddle. Concerning the soleus flap, the hemisoleus flap represents a technique to increase the arc of rotation. With a soleus flap, one must consider the soft tissue defect location, size, and perforator blood supply because these factors influence what soleus flap technique to use. This article discusses how to make the most out of gastrocnemius flaps and soleus flaps regarding maximizing coverage and ensuring successful flap outcome.
腓肠肌瓣和比目鱼肌瓣分别是用于覆盖小腿近端1/3和中间1/3软组织缺损的常用局部皮瓣。在进行局部皮瓣手术前，一个重要的考虑因素是该皮瓣能否提供足够的覆盖范围。可以采用多种技术来增加腓肠肌瓣的旋转弧，包括后中线入路、在鹅足和股骨内侧髁起点处进行解剖、切开筋膜以及包含一个皮瓣，从而提高腓肠肌瓣的实用性。关于比目鱼肌瓣，半比目鱼肌瓣是一种增加旋转弧的技术。对于比目鱼肌瓣，必须考虑软组织缺损的位置、大小和穿支血供，因为这些因素会影响所使用的比目鱼肌瓣技术。本文讨论了如何充分利用腓肠肌瓣和比目鱼肌瓣，以实现最大程度的覆盖并确保皮瓣手术成功。
