A combined biceps and semitendinosus muscle flap in the repair of ischial sores

In large or recurrent ischial pressure sores with extensive bony involvement, scarring and absence of surrounding soft tissue, radical excision of all involved bone and soft tissue leaves a large space which Conway and Griffith (1956) recommended should be filled by a biceps femoris muscle flap before being covered with a large medially based posterior thigh rotation flap. We have occasionally found the biceps so atrophied in paraplegics that it was inadequate to fill the hole. Additional bulk may be obtained by rotating the semitendinosus together with the biceps.