title: Local muscle flap in a venous hypertensive environment.
abstract: Local rotation muscle flaps are useful for soft tissue reconstruction in open grade III fractures of the lower extremity. Gastrocnemius or soleus muscle flaps provide early bone coverage and avoid a more demanding free tissue transfer. Deep vein thrombosis is common in injured limbs and venous hypertension may result in acute muscle flap necrosis. Loss of bone coverage and an increased risk of osteomyelitis follow. We present a successful soleus rotation flap for tibial coverage in a lower extremity with a documented major venous thrombosis.
authors.affiliation: Division of Plastic Surgery, Maryland Institute for Emergency Medical Services System, Baltimore.
authors.forename: T J
authors.initials: TJ
authors.lastname: Francel
authors.forename: P N
authors.initials: PN
authors.lastname: Manson
authors.forename: C A
authors.initials: CA
authors.lastname: Vander Kolk
mesh_terms: D000328:Adult; D016267:External Fixators; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D013524:Surgical Flaps / Q000379:methods*; D013924:Thrombophlebitis / Q000601:surgery*; D013978:Tibial Fractures / Q000601:surgery*; D014690:Venous Pressure / Q000502:physiology*; D014945:Wound Healing / Q000502:physiology