title: The tibialis anterior used as a local muscle flap over the tibia after soft tissue loss.
abstract: BACKGROUND
  A series of 12 extremities among 11 patients with open wounds exposing the tibia were treated using a local tibialis anterior muscle flap. There was an associated tibial shaft fracture in 11 of the 12 extremities, which were managed by external fixation or intramedullary nailing. The wounds, ranging from 1 to 15 cm in length, were located anteriorly over the middle and distal thirds of the tibia.
  
  
  METHODS
  A retrospective chart review included patients whose open anterior tibial wounds were managed with an anterior tibialis rotational flap. These patients had been treated at the Medical College of Ohio between 1995 and 1999. No patients were excluded, and all the patients had at least 1 year of follow-up evaluation.
  
  
  RESULTS
  Complete coverage was obtained in all cases. All the wounds healed without complication. All the associated tibial shaft fractures had a delayed union or nonunion, with 10 of the 11 requiring bone graft or an exchange intramedullary nail.
  
  
  CONCLUSIONS
  The anterior tibialis is a relatively easy flap to use for covering anterior tibial open wounds. The high rate of nonunion seems related more to the injury than to the coverage technique.
authors: Department of Orthopedic Surgery, Medical College of Ohio, 3065 Arlington Avenue, Toledo, OH 43614, USA.
authors: Nabil A
authors: NA
authors: Ebraheim
authors: Terry D
authors: TD
authors: Madsen
authors: Brian
authors: B
authors: Humpherys
mesh_terms: D000328:Adult; D016267:External Fixators; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000601:surgery; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000601:surgery*; D014945:Wound Healing