COVERAGE OF SOFT-TISSUE DEFECTS OF THE DI STAL THIGH UTILIZING A REVERSED BICEPS FEMORIS FLAP

We report the case of a 30-year-old female patient, who had suffered a grade III open femur fracture in a motor vehicle accident 14 weeks pr ior to being transferred to the trauma department of the University Ho spital in Bonn. Upon admission to our unit, posttraumatic osteitis, an unstable fracture following compression plating, and a soft tissue de fect of the anterolateral distal thigh were discovered. Following remo val of the hardware and stabilization of the fracture with external fi xation, the infection was brought under control. Because the patient r efused the time-consuming segmental transport utilizing the callus dis traction technique, local muscle transfer and shortening of the femur were carried out. The most lateral of the hamstring muscles, the bicep s femoris, was used as a distally based muscle flap utilizing a delay technique. With the help of a reversed biceps femoris flap, the soft t issue defect was closed, the infection subsided and the fracture heale d. The surgical technique is outlined.