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Review
. 2023 Jul 11;6(4 Suppl):e255.
doi: 10.1097/OI9.0000000000000255. eCollection 2023 Jul.

How to get the most out of your gastrocnemius and soleus flaps

Paul E Matuszewski  1 , Gary L Ulrich  1
Affiliations
Review

How to get the most out of your gastrocnemius and soleus flaps

Paul E Matuszewski et al. OTA Int. .

Abstract

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.

Keywords: gastrocnemius; soft tissue; soleus.

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Conflict of interest statement

All authors have no conflicts of interest. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
Intraoperative photograph of medial gastrocnemius flap to cover soft tissue wound. The flap is scored longitudinally to improve width-wise coverage of the flap. Alternatively, scoring width-wise can improve length excursion of the flap.
Figure 2.
Figure 2.
A, B, Traumatic injury to left knee with extensor mechanism disruption. C, The medial gastrocnemius was released to the level of its origin and rotated to cover entire defect, which extended proximal to the patella and laterally. D, This led to a satisfactory outcome.
Figure 3.
Figure 3.
A, Traumatic defect of the medial tibia in the proximal and middle third of the tibia after an auger injury. B, Both the gastrocnemius and soleus flaps are rotated and C, skin grafted. Please note that the muscle was partially damaged from the trauma but can still be rotated if viable.
See this image and copyright information in PMC

References

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