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

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

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.

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.

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.