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Resumen Objetivo: Mostrar las posibilidades quirúrgicas que existen en el tercio distal de la pierna y presentar la experiencia en los últimos 15 años con estos colgajos. Materiales y métodos: Se revisó durante 15 años los colgajos de sóleo directo e invertido, fasciocutáneos, de sural invertido y algunos colgajos libres para cubrir defectos en el tercio distal de la pierna y pie. Resultados: Se revisó a 112 pacientes con seguimiento mínimo de 3 meses; 18 tenían compromiso del tobillo y pie y el resto tenía exposiciones de tendones y/o de elementos neurovasculares. Los colgajos más usados fueron el sóleo, el sural invertido y el fasciocutáneo invertido. Se presentaron complicaciones menores, como necrosis distal de bordes, en cuatro colgajos, sin afectar la cobertura final. Un colgajo libre sufrió necrosis total. Discusión: Fracturas abiertas de tibia requieren cobertura rápida para disminuir los índices de infección y favorecer la curación. El sóleo sigue siendo de los más usados entre los colgajos locales para los defectos del tercio medio de la tibia. En esta serie se muestra que es apto para muchas reconstrucciones en la pierna distal, ya que se evita muchas veces el uso de un colgajo libre. El colgajo sural invertido es de gran seguridad y versatilidad, y llega a cubrir muchas veces defectos grandes en el dorso del pie y en el talón. Los colgajos libres son de mayor complejidad, debido a que se requiere personal especializado, así que es recomendable solucionar estos problemas con colgajos locales musculares, fasciocutáneos o neurocutáneos. Abstract Objectives: report the surgical possibilities that exist in the distal third of the leg and present the experience in the past 15 years with these flaps Materials and methods: During 15 years we performed different flaps like soleus flaps, reversed fasciocutaneous flaps, reversed sural flaps and some microsurgical free flaps to cover defects in the distal third of the leg and the foot Results: We reviewed 112 patients followed at least 3 months, 18 had ankle joint or foot exposure and the other had exposure tendons and / or neurovascular elements. The most used flaps were the soleus, the reversed sural and the reversed fasciocutaneous. Distal necrosis was observed in the edge of the four flaps, but not affecting the final coverage. One of the free flaps suffered a total necrosis. Discussion: Open tibial fracture required fast coverage to reduce infection and promote healing.The soleus muscle is still the main flap to cover the defects of the middle third of the tibia. This series shows that this flap is suitable for many distal leg reconstructions, often avoiding the use of a free flap. The reverse sural flap is very safe and versatile, and is a good option to cover defects on the dorsum of the foot and heel. Free flaps are of greater complexity requiring specialized staff. It is recommended to solve these problems with local flaps, muscle flaps, fasciocutaneous or neurocutaneous flaps.

En nuestro país la hidatidosis sigue siendo un importante problema de salud pública. Generalmente compromete el hígado y el pulmón, sin embargo, se han reportado casos con compromiso de diversos órganos, como bazo, peritoneo y otras ubicaciones. Excepcionalmente puede presentarse como un tumor de partes blandas simulando un sarcoma u otro tumor. Presentamos un caso clínico de una paciente con hidatidosis de la musculatura de la pierna derecha tratado en el Hospital Base Osorno, que simuló una fasceítis eosinofílica; además se revisa el estado del arte de la hidatidosis muscular. Hydatid cysts may occasionally be confused with soft tissue tumors such as sarcomas. We report a 43 years oíd female living in a rural zone, presenting with a painful tumor in her left leg. A CAT sean showed the presence of a solid-eystic lesion in the left soleus muscle. A biopsy of the zone was informed as eosinophilic fasceitis and steroids were indicated. Two months later a new CAT sean showed that the lesion was increasing in size. An IgG for hydatidosis was positive. The patient was subjected to a cystectomy and the pathology report informed a hydatid cyst.

Hydatid cyst of the soleus muscle. Report of one case Hydatid cysts may occasionally be confused with soft tissue tumors such as sarcomas. We report a 43 years old female living in a rural zone, presenting with a painful tumor in her left leg. A CAT scan showed the presence of a solid-cystic lesion in the left soleus muscle. A biopsy of the zone was informed as eosinophilic fasceitis and steroids were indicated. Two months later a new CAT scan showed that the lesion was increasing in size. An IgG for hydatidosis was positive. The patient was subjected to a cystectomy and the pathology report informed a hydatid cyst.