Getting the most from the soleus muscle.

Abstract

The bipennate soleus muscle has properly become entrenched as the muscle flap of choice for coverage of the middle third of the leg. Yet its potential versatility in fulfilling many other indications has been understated. With minor alterations in the methodology for transfer, often the reach of the muscle can be extended to more proximal or even distal defects in lieu of more complex solutions. Function preservation with hemisoleus flaps, the possibility of a cutaneous version, and use as a dynamic muscle demonstrate the diversity of additional alternatives. The merit of several techniques for augmenting circulation to the unreliable "reversed" soleus flap further prove the limitations of this option. Recognizing that we can often "get more" from the soleus muscle than traditionally considered deserves reemphasis.