[Restorative surgery on the lower leg using muscular shifting grafts -- anatomical and clinical aspects (author's...

The long clinical course and the great number of complications after open fracture of the lower leg are due to the thin soft-tissue layer coating the tibia. Large defects may occur here and expose the tibial periosteum. In post-mortem studies, various methods to repair pretibial defects by means of muscular shifting grafts were investigated. It is possible to cover almost the entire tibia with the aid of pedunculated muscular flaps (M. gastrocnemius, M. soleus, M. abductor hallucis). The muscles can be grafted primarily with split skin. By this, stable wound conditions are created, allowing the fracture to heal after osteosynthesis without the risk of a secondary infection. One case of repair, using the M. gastrocnemius, is demonstrated.