The cross-leg soleus muscle flap

Reconstruction of the lower limb can be a difficult problem, especially whe n located over the lower third of the leg, or when a large soft-tissue defe ct exists. When local flap coverage is not possible, a distant flap-free or pedicled-is indicated. There are, however, circumstances that preclude the use of a free flap, and in these situations cross-leg flaps remain a viabl e alternative. They have been proved to be safe, are usually quick to perfo rm, and do not require specialized facilities for postoperative monitoring. A new variation of the soleus muscle flap-the cross-leg soleus muscle flap -is described. Using this modification, the authors successfully closed lar ge defects of the lower limb in 9 patients. The donor site defect that is l eft on the contralateral limb is far more acceptable than that left by conv entional cross-leg fasciocutaneous or musculocutaneous flaps. The authors p refer the cross-leg soleus flap to conventional cross-leg flaps in these si tuations.