The distally based medial gastrocnemius flap: case report and anatomic study.

We describe a distally based flap of the medial head of the gastrocnemius, vascularized through a distal pedicle given off by the posterior tibial artery. A literature review showed that this flap and the distal pedicle had not been described previously as such, although several techniques have been used to cover a substance loss of the distal third of the leg using the medial gastrocnemius. The distal artery has a variable caliber, and it is not always possible to raise the flap. One patient has been operated on by this technique, and an anatomic study was performed showing that 9 of 30 legs had a distal pedicle larger than 1 mm, 14 had a pedicle smaller than 1 mm, and 7 had a microscopic pedicle too small to raise a flap.