[Repair of soft tissue defect by reverse soleus muscle flap after Pilon fracture fixation].

OBJECTIVE: To investigate the clinical effect of the reverse transposition of pedicled soleus muscle flap in repairing soft tissue defects after Pilon fracture fixation.

METHODS: From May 2002 to June 2006, 14 patients (11 males, 3 females; aging 20-50 years) with soft tissue defects after Pilon fracture fixation underwent repairing operations with the reverse soleus muscle flaps. The soft tissue defects ranged from 7.0 cm x 3.5 cm to 10.0 cm x 6.0 cm. Of the patients, Pilon fractures were treated by internal fixations in 9 cases, open Pilon fractures were treated by external fixations in 5 cases. The area of muscle flap ranged from 8.5 cm x 5.5 cm to 12.5 cm x 7.5 cm.

RESULTS: All patients achieved primary healings, and the grafting skin survived. Twelve flaps survived completely but 2 flaps had mild infection, which survived after dressing change. Eleven patients were followed up for 3 to 26 months, averaged 15 months. The flap appearances were good and smooth without ulceration. The dorsiflexion ranges of ankle joint were 10-25 degrees, and plantar flexion ranges were 15-40 degrees. The gait was normal.

CONCLUSION: The reverse soleus muscle flap is no need to reveal blood vessel pedicle and has constant position of anatomy. It has big muscle belly, convenient-to-move and circuitation 180 degrees. It is profitable to reduce infection rate and to promote wound healing to raise local osteotylus.