The modification of lateral gastrocnemius myocutaneous flap with extended anterior margin and its clinical application

Objective To introduce the modified lateral gastrocnemius myocutaneous flap with extended anterior margin and its clinical features.Methods The anterior margin of the flap was extended from the overlying of fibula to the crista anterior tibiae,and anterior border located in lateral border of defects.21 cases were treated with modified lateral gastrocnemius myocutaneous flaps,with 9 cases in upper 1/3 segment of the cnemis,7 in anteriomedialis of middle 1/3 segment of the cnemis,and 5 in anteriolateral of middle 1/3 segment of the cnemis.The anterior border of all flaps exceeded crista anterior fibulae,and that of 2 flaps reached to the crista anterior tibiae.The width of flap on anterial compartment of the cnemis ranged from 2.5cm to 7.0cm,averagely 4.0 cm.Results 19 flaps survived well,however,marginal necrosis of distal end above external malleolus about 5cm and 3cm respectively,occurred in 2 cases.Conclusions With the extension of the effective width and length,the modified lateral gastrocnemius myocutaneous flaps are reliable for repairing soft tissue defect.