Bipedicle gastrocnemius musculocutaneous flap for defects of the distal one-third of the leg.

A bipedicle gastrocnemius musculocutaneous flap has been designed to cover soft-tissue defects over the lower one-third of the tibia. The flap, which consists of the entire medial or lateral half of the posterior leg skin and the underlying gastrocnemius muscle, combines the advantages of the axial-pattern blood supply of a musculocutaneous flap and the dual blood supply to a bipedicle flap. The augmented circulation from the proximal end of the flap allows the distal pedicle to be narrowed and advanced anteriorly in one stage without jeopardizing the blood supply. Bipedicle gastrocnemius musculocutaneous flaps are best suited for moderate-sized defects over the anterior lower one-third of the leg. Indications for use of the flap are presented.