The management of lower extremity trauma has evolved over the last two decades to
the point that many extremities that would have required amputation are routinely
salvaged. The use of transposition muscle is regarded as the optimal method for the
treatment of extensive defects of soft tissues in limb traumatology. The aim of the study is
to investigate the therapeutic effect of repairing soft tissue defects of mid-tibia open
fractures with muscle flap pedicled with medial half of soleus. A retrospective study of our
outcome of 10 performed soft-tissue reconstruction of an open tibial wound cases. All
these patients were operated using the proposed surgical technique between 2013 and 2015
in AL-ASSAD University Hospital in Lattakia, Syria. The results of this technique of
reconstruction are excellent. Medial hemisoleus flap is a valuable option for soft tissue
coverage of middle third of lower leg. It does not sacrifice the whole function of the Soleus
muscle. Due to its longer arc of rotation, this flap can cover the defects of different size
and shape in middle third of leg. The operation is relatively easy. The muscle can fill the
narrow cavity and repair the soft tissue defect simultaneously. The donor-site injury is
minor.
