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.