Sagittal split tibialis anterior muscle flap.

Abstract

The potential use of the tibialis anterior muscle as a vascularized flap requires consideration of some function preservation technique because this is not an expendable muscle. A direct longitudinal vertical or partial sagittal split of this muscle will allow coverage of mid-tibial defects without impairing function. This is a valuable alternative for small defects, especially if the muscle is already exposed in the wound. The muscle must be malleable enough to allow stretching over the tibia, because otherwise posteromedial undermining (as used in the medial- hinged anterior turnover version) would be necessary to obtain the desired reach. This as a variation of the latter, if possible, not only is more expedient to implement but also better preserves the microcirculation of the muscle to ensure viability.