The tibialis anterior muscle flap for full-thickness tibial burns

Full-thickness burn wounds to the tibia present a challenging coverage problem. If skin grafting fails, few local options exist, and free tissue transfer may be required for coverage. We report on the use of the tibialis anterior muscle flap to cover longitudinal tibial defects in five extremities in four patients. These patients sustained 80, 55, 40, and 11% total body surface area burns. Postoperatively, all five extremity wounds healed with full coverage of the tibia. Minimal deficits in ankle inversion and eversion resulted, but all patients are fully capable of walking and able to bear weight. We feel that the tibialis anterior muscle flap is a safe, reliable, technically simple alternative for coverage of the burned tibia.