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The Gastrocnemius Flap for Lower Extremity Reconstruction
1Foot and Ankle Surgery, Plastic Reconstructive and Microsurgery, Orthopaedic Trauma, and MSK Infection Services, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.
Clinics in Podiatric Medicine and Surgery
|September 13, 2020
Summary
The gastrocnemius flap effectively covers bone in the upper leg and knee using muscle or muscle and skin. Modifications like releasing the medial femoral condyle enhance its reach for better coverage.
Area of Science:
- Reconstructive surgery
- Orthopedic surgery
- Plastic surgery
Background:
- The gastrocnemius flap is a common choice for soft tissue reconstruction.
- Coverage of the proximal tibia and knee often requires versatile flaps.
- Understanding flap limitations is crucial for successful reconstruction.
Purpose of the Study:
- To detail the versatility and application of the gastrocnemius flap.
- To explore methods for maximizing the reach of the gastrocnemius flap.
- To provide guidance on using gastrocnemius muscle and/or skin flaps.
Main Methods:
- Utilizing medial and/or lateral heads of the gastrocnemius muscle.
- Assessing flap reach limitations.
- Employing techniques to increase flap reach, including release and scoring.
Main Results:
- The gastrocnemius flap provides reliable coverage for the proximal one-third of the leg and knee.
- Flap reach is typically limited to below the knee without modification.
- Release from the medial femoral condyle and fascia scoring increase flap reach.
Conclusions:
- The gastrocnemius flap is a valuable option for reconstructing defects in the proximal leg and knee.
- Surgical modifications can significantly extend the flap's reach.
- This flap offers a robust solution when muscle or muscle and skin coverage is needed.
