The gradual expansion muscle flap

Michael J. Beltran, James A. Blair, Christopher R. Rathbone, Joseph R. Hsu

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Summary: High-energy open fractures of the tibia have traditionally been fraught with challenges to include bone comminution or loss, soft tissue loss, nonunion, and infection. A number of techniques have been implemented to treat the severe soft tissue loss typically involving the anteromedial surface of the tibia to include wet-to-dry dressings or Papineau techniques, negative pressure wound therapy, acellular dermal matrices, and rotational or free tissue transfer with Masquelet technique, primary shortening, and distraction osteogenesis to address bone loss. We present a novel technique and subsequent case series that obviates the need of free tissue transfer while treating high-energy type IIIB open tibia fractures by performing an acute shortening and angulation of the tibia and rotational muscle flap coverage and split-thickness skin grafting of the soft tissue defect. Distraction histiogenesis with circular external fixation is then used to correct the residual osseous deformity while stretching the rotational muscle flap.

Original languageEnglish (US)
Pages (from-to)e15-e20
JournalJournal of Orthopaedic Trauma
Issue number1
StatePublished - Jan 2014
Externally publishedYes


  • Flap coverage
  • III-B tibia fracture
  • Shortening and angulation
  • Taylor Spatial Frame

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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