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The Flexor Digitorum Longus Muscle Flap for the Reconstruction of Soft-Tissue Defects in the Distal Third of the Leg: Anatomic Considerations and Clinical Applications

Durand, Sebastien MD; Sita-Alb, Laura MD; Ang, Sopiep MD; Masquelet, Alain-Charles MD, PhD

doi: 10.1097/SAP.0b013e3182503c16

Soft-tissue defects of the distal third of the leg are common occurrences in trauma centers. The authors present the anatomic basis and their clinical experience using the flexor digitorum longus muscle flap. Ten cadaver specimens were dissected to evaluate the potential use of this flap for soft-tissue coverage in the lower third of the leg. Eleven patients underwent a soft-tissue reconstruction in the distal third of the leg with this flap. The average size of the defect covered by this flap was 11.3 cm2. This transfer flap was used in 7 cases exclusively or in combination in 4 cases. No functional deficit and good plastic result were observed in all cases. Ease of elevation and reliability has made this transfer flap the procedure of choice for small soft-tissue defects over the proximal portion of the distal tibia in our institution.

From the Department of Orthopaedic, Traumatologic and Reconstructive Surgery, Hospital Avicenne, Bobigny; and Institute of Anatomy, Paris, France.

Received May 13, 2007, and accepted for publication, after revision, February 13, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Sebastien Durand, MD, Department of Orthopaedic Surgery, Bichat hospital, 46, rue Henri-Huchard, 75018 Paris, France. E-mail:

© 2013 by Lippincott Williams & Wilkins