Introduction/Background:

The traumatic complex wound of lower one third of leg with exposed bone remained challenge for reconstruction. In the literature, for smaller defect local fasciocutaneous flaps are described and free tissue transfer for medium to large defect.

By taking advantage of cross communication of blood supply between the lower part of gastrocnemius and soleus muscle, the author has designed these two muscles as combined pedicled flap based on gastrocnemius muscle blood supply for complex wound reconstruction of lower one third of leg to salvage the limb. Our strategy for skeletal reconstruction is for bone gap less than one inch, reconstruction performed by bone graft and if bony gap more than one inch then segment transport.