Cases of Distal Lower Leg Reconstruction with Flexor Digitorum Longus Muscle Flaps.

Lee, Seung Hyun; Lee, Hye Kyung; Cho, Pil Dong

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(6):835-838.
Published online November 1, 2010.

Cases of Distal Lower Leg Reconstruction with Flexor Digitorum Longus Muscle Flaps.

Seung Hyun Lee, Hye Kyung Lee, Pil Dong Cho

Department of Plastic & Reconstructive Surgery, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea. pildong@naver.com

Abstract

PURPOSE
Reconstruction of soft tissue defects in the distal lower leg, especially in the distal third, largely depends on free tissue transfer and local fasciocutaneous flaps. But several local muscle flaps have also been proposed as useful alternative reconstructive manner. In this report, the authors present the successful use of the flexor digitorum longus muscle flaps in the distal lower leg reconstruction. METHODS: Case 1: An 81-year-old woman with a dog bite wound in the left distal lower leg was admitted. She had a 10 x 8 cm wound with tibial exposure along the medial aspect of the leg. Soft tissue reconstruction with a flexor digitorum longus muscle flap and a split-thickness skin graft was performed. Case 2: A 77-year-old woman had a squamous cell carcinoma in the right distal lower leg. After wide excision, a 5 x 4 cm wound was developed with exposure of the tibia. The flexor digitorum longus muscle flap was transposed and covered with a split-thickness skin graft.
RESULTS
The flexor digitorum longus muscle flaps were shown to be useful to cover tibial defects in the distal lower leg. During the follow-up period, no significant donor site morbidity was found.
CONCLUSION
The flexor digitorum longus muscle flap can be used to cover the exposed distal tibia, especially when a free tissue transfer is not an option. The relative ease of dissection and minimal functional deficits were the major advantages of this flap, while the extent of reach into the lower third has a limitation.

Keywords: Flexor digitorum longus; Muscle flap; Distal lower leg reconstruction