Soleus flap

The Soleus Muscle Flap: An Overview of Its Clinical Applications for Lower Extremity Reconstruction Ann Plast Surg. 2018 Dec;81(6S Suppl 1):S109-S116. doi: 10.1097/SAP.0000000000001499. Authors Ping Song 1 , Lee L Q Pu. Affiliation 1 From the Division of Plastic. Soleus Muscle Flap. - Discussion: - soleus is a bipiniform (double feather) shaped muscle; - its width encompasses the posterior two thirds of the calf; - it originates from the upper one third of the dorsum & medial surface of the fibula and mid-posterior tibia; - it inserts into the achilles tendon over a 5 cm area just anterior and distal to. We review the versatility and reliability of the soleus muscle as a local muscle option once the technique is mastered on how to safely and effectively design and execute this flap. We highlight the importance of an algorithmic approach to soft-tissue reconstruction of the lower extremity based on the best surgical option for the patient Soleus is the standard muscle flap of choice for middle third defects of the leg. Numerous limitations with bulk, arc of rotation and weakening of plantar flexion when using the entire muscle. Medial hemisoleus muscle flap can be elevated based either proximally or distally depending on the location of the soft tissue reconstruction required

Anatomy Of The Soleus Muscle - Everything You Need To Know

The Soleus Muscle Flap: An Overview of Its Clinical

Soleus Muscle Flap : Wheeless' Textbook of Orthopaedic

  1. Dr. George Dreszer, M.D.Medial Soleus reconstruction of middle third gustilo IIIb wound of lower leg
  2. After a gastrocnemius or soleus muscle flap is completed, range of motion of the knee and ankle are usually started during the first week. Figure 46.21. A split-thickness skin graft measuring between .015 and .018 inches can be placed immediately after successful flap transposition. To improv
  3. ant vascular pedicles of the soleus are branches of the popliteal artery, branches of the posterior tibial artery (medial belly), and branches of the peroneal artery (lateral belly). 14, 5
  4. Soleus flap is an extremely useful flap in acute management of compound fractures of lower leg especially middle and lower third. However, the soleus being in zone of trauma in such defects, reconstructive surgeons hesitate to use it primarily. This article proposes a novel way of using the soleus
  5. The soleus muscle flap. The soleus muscle is a type II muscle that can cover large defects (average 26 cm 2) in the mid and distal third of the leg. Its musculotendinous junction 26 averages 6.0 ± 1.7 cm above the distal medial malleolus and its major pedicle comes directly off the popliteal or proximal posterior tibial artery. Numerous (4.

Indications. The gastrocnemius muscle is routinely used for soft tissue loss and bone coverage over the proximal one-third of the tibia. For the middle tibia, the [soleus flap] is used, and distal to that a [free flap] is needed.. Either the medial or lateral heads of the gastrocnemius can be used, though the proximity to the Peroneal nerve and its shorter length make the lateral less desirable • Used for wound coverage over distal third of tibia, or in the middle and proximal leg when soleus and gastrocnemius are damaged Groin flap • Axial flap that has been a mainstay of providing soft-tissue coverage of the upper extremit About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators. The soleus perforator flap basically is a true perforator flap with a short pedicle, consisting of septo- or septomyocutaneous perforators on which anastomoses are performed; thus, none of the main vessels of the lower leg has to be sacrificed. The perforators mostly arise from the peroneal vessels and are exposed at the proximal half of. Open wounds in the middle third of the lower leg often require soft tissue reconstruction to allow for primary wound healing. The soleus muscle flap is uniquely suited for this purpose and is used primarily as a muscle flap without the accompanying overlying skin. This muscle has a blood supply that is segmental in nature, arising from multiple perforators from the posterior tibial vessels

A muscle flap. Usually not used as a free flap. Microsurgery can augment medial gastroc use as a local flap by extending the reach of the muscle. Innervation: Separate branches for the medial and lateral gastrocnemius muscles, via the posterior tibial nerve. Blood supply: Medial sural artery and vein. Artery: Typically over 1 millimeter in. Soft tissue defects of the lower limb are a formidable challenge to the plastic surgeon but a soleus muscle flap often provides the solution. Various types of soleus muscle flap have been described, based mainly on the vascular supply. The arterial blood supply of the soleus muscle was studied in 50 Soleus flap is an extremely useful flap in acute management of compound fractures of lower leg especially middle and lower third. However, the soleus being in zone of trauma in such defects, reconstructive surgeons hesitate to use it primarily. This article proposes a novel way of using the soleus muscle by sliding it across the defect and not. 15570* Formation of direct or tubed pedicle, with or without transfer; trunk 15731* Forehead flap with preservation of vascular pedicle (e.g., axial pattern flap, paramedian forehead flap) 15732* Muscle, myocutaneous, or fasciocutaneous flap; head and neck (e.g., temporalis, masseter muscle, sternocleidomastoid, levator scapulae) 15734* Muscle, myocutaneous, or fasciocutaneous flap; trun

The flap can be used to cover a portion of the distal tibia by extending the soleus muscle using several relaxing incisions in the epimysium. This procedure is less time-consuming and simple [ 19 ]. The elective indication of proximal-based flap is coverage of defects in the middle third tibia of the leg A local flap solution to this problem is the utilization of a combined pedicled gastrocnemius and hemi-soleus flap, first described in 2004 by Hyodo et al. 4 This flap utilizes either the medial or lateral head of the gastrocnemius, which is combined with a hemi-soleus as a contiguous double muscle flap based on the inter-muscular perforators.

  1. Defect coverage oropharyngeal or at the upper extremity by free soleus flaps. Indications Defects of the proximal and middle thirds of the anterior lower leg for the proximally pedicled soleus flap; defects of the middle and distal third of the anterior lower leg for the distally pedicled soleus flap. The free flap is almost ubiquitously useable
  2. This chapter describes the key steps of a pedicled soleus muscle flap for soft tissue coverage of the middle third and certain distal third tibial defects. Specifically, indications, step-by-step instructions, postoperative care, and variations are listed. A sample dictation is also provided
  3. Use of the soleus musculocutaneous perforator for skin paddle salvage of the fibula osteoseptocutaneous flap: anatomical study and clinical confirmation. Wong CH(1), Tan BK, Wei FC, Song C. Author information: (1)Department of Plastic, Reconstructive, and Aesthetic Surgery, Singapore General Hospital, Singapore

Facility billed 83.82 which is 'other plastic operations on muscle, tendon & fascia, graft of muscle of fascia.'. Well op report states 'soleus rotational muscle flap for coverage of right lower extremity middle third defect.'. Does this procedure code look right? Can anyone provide guidance on the best route to take when coding flap procedures Structure. The soleus is located in the superficial posterior compartment of the leg.. The soleus exhibits significant morphological differences across species. It is unipennate in many species. In some animals, such as the rabbit, it is fused for much of its length with the gastrocnemius muscle.. In humans, the soleus is a complex, multi-pennate muscle, usually having a separate (posterior.

The gastrocnemius or soleus flap alone is not sufficient. Combined gastrocnemius-soleus flaps can be used adequately without the need to resort to free flaps. We review the use and outcomes of the combined pedicled gastrocnemius and hemi-soleus double muscle flap to cover large defects of the leg and discuss our technique Traditionally, cross-leg flaps and microsurgical flaps have been used to reconstruct defects of the distal third of the leg. In the authors' experience, the soleus muscle has also provided suitable tissue for coverage of these lesions in a notable number of cases. During a 2-year period, the authors treated 28 patients who required flap coverage of defects of the lower third of the leg dial soleus flap, and definitive bone reconstruction using a vascu-larised free fibula flap. In the first phase of surgery, the lesion was cleansed by plas - tic surgeons, operating on the skin, the soft tissues and the bone. The orthopaedic surgeons stabilised the bone by external fixation

The study concluded that as it is richly supplied with arterial blood, the soleus can be used safely as a free flap, hemisoleus flap or composite flap to cover defects in the lower limb. Zawawy, Ehab & El-Sekily, Nancy. (2012). An anatomical study of the blood supply of the soleus muscle in humans. Alexandria Journal of Medicine. 48 • Soleus flap • Narrower muscle belly compared to gastrocs and a somewhat less robust vascular supply • Less tolerant of tension compared to gastrocs flap so harvesting and mobilization of muscle belly can be technically demanding . Soft Tissue Coverage for the Distal 1/ The soleus muscle is a wide flat leg muscle found on the posterior leg.. It runs from just below the knee to the heel and lays immediately deep to the gastrocnemius.These two muscles, along with the plantaris muscle, belong to the group of superficial posterior compartment calf muscles.Soleus' contraction results in strong plantar flexion.It also allows us to maintain an upright posture due. return to: Nursing ProtocolsI. Purpose of flap: a. Reconstruction after tumor excision, trauma, post-osteoradial necrosis. b. Protection of the greater vessels. c. Correction of congenital defect.II. Types of flap: a. Pedicle: one end of the flap remains attached to the original site and the other end is moved to cover existing defect I think repair CPT's 13121 and 13122, Dx 891.1, but what CPT should I use for the gastroc soleus repair. Indications: Deep laceration from a surfing accident on the left proximal gastrocsoleus. There was a large gash in proximal gastrocsoleus complex. This was a complicated wound measuring at least 11 cm in length

Microsurgery information for surgeons, health care professionals and patients, with detailed procedure descritpions Soleus is a bipennate muscle with independent blood supply of each half. Using one half retains its important function, increases arc of rotation, and makes it easy to orientate for coverage of defect of any shape thus obviating the need for use of whole Soleus muscle flap. Due to this geometrical advantage, it is a superior option than the. leg_anatomy_soleus 3/10 Leg Anatomy Soleus illustrations focused on flap harvest, markings, and reconstruction keep you abreast of today's latest developments. Includes high-quality illustrations of regional anatomy, flap anatomy, and step-by-step flap dissections, as well as clear photographs demonstrating successful reconstructions Flap type and blood supply to soleus flap. Type II Dominant: Proximal branches of posterior tibial and peroneal arteries Minor: Segmental branches of posterior tibial. Innervation to soleus flap. Non-sensory Motor: posterior tibial, medial popliteal. Flap type and blood supply to trapezius The reversed flow hemisoleus flap supplied by the posterior tibial artery is another alternative in reconstruction of lower third leg skin defects but it has the great disadvantage of sacrificing a major leg blood vessel. To overcome the problems associated with these two techniques, the island soleus muscle flap was described

Although, gastrocnemius flap was introduced since 1978 is still the most commonly used flap for knee coverage, due to its reliable axial blood supply and ease of dissection. The gastrocnemius flap is a type I (single vascular pedicle) according to the Mathe et al [ 31 ] classification with dominant vessel in most patients the media sural artery based soleus muscle flap for the treatment of com-plex wounds of the lower legs, this study aimed to treat specifically patients with defects in the middl Soleus Flap for Middle/distal 1/3 Tibial Wound Coverage. By Janet Conway 14 Videos. February 28, 2018. This video demonstrates via cadaver dissection the technique for using a soleus flap advanced medial read more ↘ Free flaps. • Used for wound coverage over distal third of tibia, or in the middle and proximal leg when soleus and gastrocnemius are damaged. Groin flap. • Axial flap that has been a mainstay of providing soft-tissue coverage of the upper extremity. • Based on thesuperficial circumflex iliac artery

Colum’s Legs and Other Things, Too! – Outlander Anatomy

Soft Tissue Coverage of Lower Leg—Soleus Flap Plastic

Summary of Soleus Air advantages: Low profile, super-quiet operation, and easy installation. Over-the-sill air conditioners are the new revolutionary types of AC units.It's not a far-fetched dream that in 10 years, everybody will replace their existing window AC units with the new saddle air conditioners Figure 2 Intraoperative (A) Excision of Chronic Wound (B) Incision and dissection of medial soleus (C) Closure with application of External Fixation for ankle motion and flap protection. The decision was made to transpose a medial hemisoleus muscle flap for coverage of the defect

The Pedicled Soleus Muscle Flap for Coverage of the Middle

  1. 4. Anteromedial thigh flap Femoral artery lies in subsartorial canal for its lower 2/3, and in this portion gives off muscular and fasciocutaneous branches Perforators pass around both borders of sartorius to form a plexus at the level of the deep fascia with an axis along the border of sartorius Range in size from 0.5-1mm Ø 80% cases the.
  2. The possibility for use of the HSMF as a myocutaneous flap is given as well [27]. The soleus muscle being the prime ankle plantar flexor and stabilizer of the ankle and cannot be sacrificed completely without significant morbidity. The consistently bipenniform neurovascular anatomy allows longitudinally splitting the muscle for transfer of one.
  3. The flap remains attached now primarily by the vascular pedicle, the soleus, and the flexor hallucis longus. With care not to injure the septocutaneous or musculocutaneous perforators to the skin paddle, dissect these muscles away from the bone flap posteriorly. The flap now remains attached only by the vascular pedicle
  4. ed after reconstruction with a soleus muscle flap. The results were compared with a control population (group B: 9 patients). Each patient performed at least 3 gait tests at a fast pace, 2 posture tests and 2 HRT on an inclined plane

Soleus Perforator Flap SpringerLin

50 Gastrocnemius Flap, 570 Alain-Charles Masquelet, Paolo Sassu, Marco Innocenti Expert Commentary Geoffrey G. Hallock 51 Soleus Flap, 581 Jacques Baudet, Philippe Pelissier, Vincent Casoli, Philippe Caix, Félix J. Farías, Wieslawa De Pawlikowski Expert Commentary Randy Sherman and Michael J. A. Klebuc 52 Fibula Flap, 59 Mathes-Nahai Musculocutaneous Flap Classification [Mnemonics] The vascular anatomy of muscles was classified into 5 types by Stephen J. Mathes and Foad Nahai in 1981. It is still the most accepted classification used for choosing and designing a muscle and musculocutaneous flap for its use in reconstructive surgery

First- Medial gastrocnemius flap, Brachioradialis flap, Soleus flap. Also, popularized pedicled muscle flaps for limbs (first described by W J Stark). 1967: Miguel Orticochea (Colombia) First described- Four-flap Scalp reconstruction technique. In 1971- he refined it to Three-flap Scalp reconstruction technique. 1967: Toyomi Fujino (Japan The Soleus Flap is used for coverage of defects of the middle third of the lower extremity. High energy wounds to the lower extremity that cause exposure of the underlying bone and fracture are best treated with coverage with this muscle. the fascial plane between the soleus and deep compartment, starting on the medial edge, at the proximal portion of the flap. If the interval between the soleus and gastrocnemius is entered inadvertently, this becomes obvious when the plantaris tendon comes into view. Isolate the posterior tibial vessels, clamp and cu

Gastrocnemius and Soleus Rotational Muscle Flaps: Soft

Lower Limb Muscle Flaps w/ Skeletal Stabilization Part 1-Medial Soleus. By Orthofix US Extremities FEATURING Mikhail Samchukov , Edgardo Rodriguez-Collazo. October 1, 2018. Dr.Rodriguez demonstrates a cadaveric disection of a medial soleus muscle flap. 25:17 Osteomuscular flap. The entire lateral half of the soleus muscle can be harvested together with the fibula flap. The dissection is similar to that already described except that after completing the anterior dissection of the fibula, carry this in a posterior plane located between the lateral head of the gastrocnemius and the soleus until the. thickness by interposition of the soleus muscle. Fur- ther distally, the barrier formed by the popliteus mus- cle is replaced by the flexor digitorum longus and the tibialis posterior muscles (Figures 2 and 3). An advan- tage with the flap is the good coverage of the femoral condyles. Acknowledgement We wish to thank Dr

Soleus Flap - YouTub

Best Local Flaps for Lower Extremity Reconstruction

Soleus Muscle - an overview ScienceDirect Topic

Diagram of the cross section of the lower limb showing

Gastrocnemius Rotation Flap - Technique - OrthopaedicsOne

Distal extremity local flaps - Medial plantar flap, Peroneus Brevis, gastroc, soleus/hemi soleus, pedicled MSAP: Asmat Din, Ian King: Day 2 Register. Wednesday 21st July 2021. ENT. Time Activity Lecturer; 09:00: (extravesical vs intravesical), psoas hitch and Boari flap re-implantation: A Alanbuki: 1300: Introduction to renal trauma: P. Beck, J.B., Stile, F., Lineaweaver, W. Reconsidering the soleus muscle flap for coverage of wounds of the distal third of the leg. Ann. Plast. Surg. 50: 631, 2003. Pu, L.L.Q. Successful soft-tissue coverage of a tibial wound in the distal third of the leg with a medial hemisoleus muscle flap

Extremity Flap Reconstruction - Hand - Orthobullet

Stand next to the fuel flap and lower your ear to it. Using the Key Remote unlock the Driver's door ONLY. As you do listen to the fuel flap. If it is working correctly you should hear it 'click'. This is the lock 'actuator', a switch that controls the actual lock on the fuel flap. if it doesn't click it has failed. it will need to be replaced The soleus muscle flap is a versatile flap that can be used to cover soft tissue defects in the lower limb. It is grouped as a type II muscle flap.The muscle is supplied by large and small vascular pedicles (1).Previous study reported that soleus as a bipennate muscle wit Chen, TM, Jeng, TY, Wang, H-J, Chang, KC, Lin, HC, Loong, YT & Liu, HC 1989, ' Soleus muscle flap in leg reconstruction ', Journal of Surgical Association Republic of. The soleus flap may cause some functional impairment in lower extremity motion, while free flaps have potential donor site morbidity. The tibialis anterior muscle flap has been described for coverage of leg defects with exposed tibia.2 Moller-Larsen and Petersen3 made an important con A new variation of the soleus muscle flap--the cross-leg soleus muscle flap--is described. Using this modification, the authors successfully closed large defects of the lower limb in 9 patients. The donor site defect that is left on the contralateral limb is far more acceptable than that left by conventional cross-leg fasciocutaneous or.


45 soleus perforator flap, resulting in a successful outcome. Pedicled soleus perforator 49 We conclude that the pedicled soleus perforator flap is a favorable option for 50 defect coverage around the , because of its fast and easy harvestknee ing and 51 very good esthetic results. 46 flaps enable the reconstruction of local soft-tissue defects. The flap territory extends from the superior flexion crease of the calf at the popliteal fossa to the junction of the middle and inferior thirds of the posterior calf. The flap is designed in the calf and includes a line representing the course of the superficial sural artery either in the center or in the lateral part of the calf musculocutaneous flap (GMCF) is the potential donor site morbidity, particularly when a wide skin paddle is taken, due to the exposed soleus muscle raphe and Achilles tendon that do not take skin graft very well3. To overcome this, we have limited the width of the skin island whenever possible an 7. Guyuron B, Dinner MI, Dowden RV, Labandter HP (1982) Muscle flaps and vascular detour principle: The soleus. Ann Plast Surg 8: 132 PubMed CrossRef Google Scholar. 8. Levante S, Masquelet AC, Nordin JY (2009) Coverage of chronic osteomyelitis of the ankle and the foot using a soleus muscle island flap, vascularized with retrograde flow on the. Beck (2003) reported that the soleus muscle is a valuable tool for flap coverage of wounds of distal third of the leg [9]. Our premise in the present study is that awareness of this soleus muscle variant is imperative as one could diagnose its presence preoperatively by MRI scanning. Thus, thi

In 5 patients with soft tissue defect in distal third of leg repair was complete but in 3 of them flap failure was seen. Overall success rate for reverse soleous flap was 72.7%. Conclusion: The success rate of the flap for the upper and lower thirds was similar to other studies and seems that this is the standard method Peroneal artery perforator flap CHF 0.00 Add to basket; Soleus Muscle flap (proximally, distally and composite flap) CHF 0.00 Add to basket; Lateral supramalleolar cutaneous flap CHF 0.00 Add to basket; Medial Gastrocnemius myocutaneous flap CHF 0.00 Add to basket; Medial Gastrocnemius myocutaneous flap CHF 0.00 Add to basket; Antero-lateral.

Soleus Flap for Lower Leg Reconstruction - Oxford Medicin

The decline of free flap surgery in lower limb reconstruction 1. The decline of free flap surgery in lower limb reconstruction Level D evidence Dr Vaikunthan Rajaratnam Senior Consultant Hand Surgeon Department of Orthopaedic Surgery KTPH Alexandra Health Singapore 5th International Conference on Plastic Surgery 'PlastiCon 2017' Dhaka, 28 February 201 A soleus flap as a local reconstructive option for soft-tissue coverage of a tibial wound in the distal third of the leg has never been well recognized. In a 2-year period, seven patients underwent reconstruction of a less extensive tibial wound (4 × 3 to 10 × 4 cm) in the distal third of the leg after orthopedic trauma with the laterally extended medial hemisoleus flap. The flap was. COMPOSITION. An osteoseptocutaneous flap (however, it is possible to include muscle with the flap eg soleus). PEDICLE. Artery: Peroneal Artery (1.5 - 4mm) Vein (s): 2 Venae of the artery. - Branch of the posterior tibial artery (arising 2.5cm from it's origin). - Supplies the fibula via medullary & segmental periosteal vessels 6) Objective To observe the value of soleus muscle flap repairing the wound surface with the bone leaked out on the crus. 7) Soleus muscle of two lower limbs was harvested at 7 weeks old. 8) Compared with gastrocnemius and soleus muscle, gastrocnemius muscle acoustic signal' approximate entropy increases faster, but Soleus muscle acoustic.

Chinese flap. Posterior interosseous flap. Gastrocnemius muscles. Soleus flap. Flexors & extensors muscle flaps. Saphenous flap. Latissimus dorsi and scapular flaps. Sural flap. Supramalleolar flap. Lateral arm flap. Brachio-radialis flap and ulnar flap. Antero-lateral flap. Free fibula; Scientific Programme : Final Programme (PDF document. The soleus muscle flap has been useful in treating small to moderate sized defects but is limited by its small distal rotation arc . The use of proximally based peroneus brevis as a pedicled muscle flap was first described by Pers and Medgyesi [ 26 ]

Internet Scientific PublicationsRBCP - The use of soleus muscle flap in musculocutaneusLocal Flaps For Lower Limb Reconstruction Version1Micro vascular free flaps used in head and neck

The function of the gastroc at the knee is to work with your hamstrings to flex, or bend, your knee joint. Because it is a two joint muscle, the gastrocnemius is prone to quite a bit of use, and overuse, while functioning. This can lead to problems with the muscle. Anatomy and Function of the Lower Leg Muscles The skin paddle was *** cm in dimension. A cuff of soleus muscle was then completed to insure that any intramuscular branches to the skin paddle were included. A heavy scissors was then used to cut the muscle from an inferior to superior direction. The flap was then sutured to the floor of mouth and ventral tongue with 3-0 Polysorb in a. Post-operatively, the soleus flap was non-viable and required operative debridement surprisingly with an intact doppler signal throughout the pedicle of the soleus. Ultimately, a microvascular gracilis reconstruction was performed, heparin bolus was given intraoperatively, and continued as a drip post-operatively with a target goal PTT of twice. The vascularised free fibular •flap (FFF) is the most commonly used flap in head and neck for bony reconstruction. It is a vascu-larised free composite flap containing bone and muscle, with or without skin and pro-vides reliable single-stage reconstruction • Soleus • Peroneus longus. posterior myocutaneous flap (PMF) with a soleus myodesis and gastrocnemius tenodesis. We have found this technique to be reliable, durable, and favored by prostheticians. The PMF uses the superficial posterior compartment mus-culature, perfused by the medial and lateral sural arteries, to provide well-perfused soft-tissue coverage over the tran Objective To observe the value of soleus muscle flap repairing the wound surface with the bone leaked out on the crus. 目的 探讨 应用 比目鱼 肌 肌 瓣 修复 小腿 软组织 缺损 合并 骨 外露 的 临床 价值