To assess the clinical effect of using a pedicled muscle flap in the treatment of soft tissue defect in type IIIC open tibial fractures.

Between January 2011 and October 2016, 17 patients with type IIIC open tibial fractures were treated with a contralateral hemisoleus muscle flap pedicled on the posterior tibial artery. They ranged in age from 26 to 49 years (mean, 36 years). The size of the soft-tissue defects ranged from 8×8 cm to 13 cm×7 cm. The immediate coverage of the muscle flaps and vessel pedicle were performed using a meshed split-thickness skin graft. The donor site was closed directly.

All the muscle flaps had survived completely. No clinical vascular deficiency was found on the muscle flaps postoperatively. One case developed a small area of skin graft necrosis on the distal muscle flap, which healed after 2 weeks of dressing changes. The follow-up period ranged from 2.8-5.5 years (mean, 3.9 years) postoperatively. The tibia and fibula fractures healed. A good contour was confirmed at the recipient area. Satisfactory clinical results were obtained in this series.

Pedicled muscle flap is suitable for treatment of type IIIC open tibia fractures and reduces the injury to donor site.