Efficacy and Versatility of the Medial Hemisoleus Flap for Complex Middle Third Tibial Defects: A Presentation of 2 Cases

Abstract

Soft tissue injuries involving the middle third of the tibia can present significant clinical challenges, often leading to complications such as infection and nonunion. This article explores the efficacy of the medial hemisoleus flap as a valuable surgical technique for addressing these complex wounds. Two case reports are presented to illustrate the successful use of this flap in clinical practice. The medial hemisoleus flap offers consistent blood supply, improved arc of rotation, and reduced donor site morbidity, making it an excellent choice for reconstructive surgery in this anatomical region. In the first case, a 17-year-old patient with a history of smoking developed an open fracture in his left leg two years after a car accident, which led to a soft tissue defect with exposed bone in the middle third of his left leg. In the second case, a 25-year-old male involved in a traffic accident presented with a displaced open bone fracture of the middle third of the tibia and fibula with bone sequestrum. Surgical technique, advantages, patient selection criteria, and outcomes are discussed, highlighting the significance of the medial hemisoleus flap in addressing these challenging wounds.