Compound functioning free muscle flap transplantation (lateral half of soleus, fibula, and skin flap)

The functioning free-muscle transfer is a microneurovascular technique that has proven effective for patients who have a major muscle or muscle group loss for which no other less complicated procedures are available. A new functioning muscle (lateral half of the soleus) transfer was used for forearm reconstruction. This functioning muscle can be transferred alone, or it can be used with overlying skin or nearby fibular bone or both. It was used in a selective complicated case in which not only were major functional muscles lost, but a bone deficiency and skin loss also were seen. The operation was done in one stage with the composite flap (muscle plus bone plus skin). The recovered transferred muscle provided adequate strength and excursion for a functional hand and forearm.