THE DISTALLY BASED SPLIT SOLEUS MUSCLE FLAP

A refinement of the previously described distally based soleus muscle flap is proposed. The essential features of the flap are mobilisation of the tibial origin, splitting the muscle longitudinally, partially along a distinct anatomical plane, and preservation of anatomical continuity of the muscle. We suggest that improved blood supply to this flap derives from the intact major lateral proximal pedicles via the intact lateral portion into the flap. We also think that minimal damage to intramuscular vasculature integrity contributes to the improved circulation. The flap has been designed and studied using ten fresh cadaver leg dissections. Angiographic studies proved adequate blood supply to the flap. The flap has been tested eight times on seven patients with favourable results.