الفهرس 
Chapter 1: Soft Tissue Leg DefectsOnly 14 pages are availabe for public view
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Abstract
Despite recent advances in microsurgical techniques, leading to major improvements in the quality of lower limb reconstruction, coverage of lower leg defects by local or regional flaps remains indicated in selected cases. Although the free flap covers the defect successfully in a one-stage operation, it requires a long operative time; experienced, skillful technique; and patent vascular status of the recipient site. Very often, certain patients may not be candidates for free transfer tissue because of their overall medical conditions or not being in compliance with proper postoperative care after free tissue transfer. A reconstructive option providing supple tissue, while avoiding the complexity and the high technical demand of free flaps, is a welcome alternative. Free flap transfer to the lower limb in chronic post-traumatic conditions is known to have a higher complication rate with flap loss in up to 10% of cases, mainly due to the recipient vessel The dissection of these vessels often leads to refractory spasm, due to the so-called post-traumatic vessel disease (PTVD) . In conclusion, gastrocnemius muscle flap with its axial pattern of blood supply have had significant impact on reconstructive surgery and have revolutionized the management of large composite tissue defects. Also, gastrocnemius muscle flap provides enough volume and length to repair large defects of the upper third of the leg and knee joint when proximally based and middle third of the leg when distally based, and we believe that this flap still a perfect choice to reconstruct such lesions .