NEGATIVE EFFECTS ON FOOT FUNCTION AFTER LOCAL MUSCLE FLAPS OF THE LOWER LEG

Although local muscle flaps of the lower leg are often used, the funct ional problems that arise after these reconstructive procedures have n ot yet been adequately studied. Twenty patients who had undergone a lo cal muscle flap of the lower leg 3 years earlier were studied using a isokinetic muscle test. The isokinetic muscle strength profile during flexion of the foot was reduced by up to 21 +/- 16% after transfer of the m. gastrocnemius and by up to 31 +/- 20% after transfer of the m. soleus at a angular velocity of 120-degrees. The isokinetic muscle str ength profile during pronation and supination of the foot at an angula r velocity of 120-degrees was reduced by up to 89 +/- 32% after transf er of the m. soleus. Statistically, compound tibia fractures without a local flap for soft tissue therapy showed significantly better result s. In view of this functional loss, the use of local muscle flaps, par ticularly the transfer of the m. soleus, should be restricted in young er patients, and alternative techniques (free naps) should be used.