Experiencia en reconstrucción de tercio distal de pierna con colgajo libre de músculo gracilis

Reconstruction of distal lower extremity defects with exposed bone or joint usually require free tissue transfer as the only viable option. These are used in the rescue of lower extremities at risk due to trauma, infection, ulceration, burns and tumors. The gracilis muscle free flap is described in the literature as an excellent alternative. The aim of this study is to describe patient characteristics and results using the gracilis muscle free flap in reconstruction of distal third of the leg defects. This is a retrospective and observational study. A review of clinical and photographic archives of 7 patients operated by the authors between 2007 and 2010 was performed. We operated on 4 men and 3 women with a mean age of 38.5 years. The defect coverage that led to surgery (up to 20 x 6 cm) was due to an open fracture (Gustilo type III) and chronic osteomyelitis. Flap coverage was performed in all cases with partial-thickness skin grafts. There were no minor or major complications on donor or recipient sites, with satisfactory functional and aesthetic results. The gracilis muscle free flap is a good alternative for reconstruction of distal leg defects in open fractures and osteomyelitis or chronic ulcers. After follow-up all of our patients achieved a full and stable coverage.