Colgajo de músculo sóleo con pedículo proximal. Alternativa vigente para la cobertura de grandes fracturas expuestas en el tercio medio de la pierna

Abstract

Exposed fractures with significant soft tissue losses in the leg represent a challenge for the reconstructive surgeon, there are few alternatives for covering the middle third, there is currently a boom in reconstruction with microvascular free flaps, with excellent results, but requiring a complicated logistics and long surgical time, in addition to special care, a situation not feasible in many health homes. The soleus muscle flap is a current option due to its large muscular body, its good irrigation to the fracture site and its simple surgical technique. We present the case of a 21-year-old man with a history of drug use who, as a consequence of a traffic accident, presented an exposed Gustillo IIIB fracture. This fracture required the performance of several surgical cleanings to remove devitalized tissue. The leg was salvaged with fixation with an endomedullary nail and simultaneous coverage with a soleus muscle flap without complications and subsequent placement of a skin-free graft. The patient's evolution was favorable.