An 8 cm. by 10 cm. soft tissue defect over the proximal third of the tibia with exposed bone devoid of periosteum is best treated with:

B. Gastrocnemius rotational myoplasty.

DISCUSSION: The proximal third of the tibia can be covered effectively with the gastrocnemius rotational flap using the medial hem of the gastrocnemius. The middle third can be successfully covered by the soleus myoplasty. Open fractures with soft tissue defects over the distal third usually require free tissue transfer because of lack of available local tissue coverage.