Purposes: The current study aimed to focus on versatility of superiorly based pedicled gastrocnemius muscle flap or myocutaneous flap either medial or lateral head, in upper leg defects after trauma or tumor excision and importance of these flaps to improve bone healing in trauma & ensure adequate safety margin in malignant tumors with minimal complications. Patients and methods: A prospective, randomized trial was conducted to Twenty-seven patients suffering from upper leg defects after trauma or tumor excision to compare postoperative outcomes especially bone healing with the use of superiorly based pedicled gastrocnemius muscle flap covered by split thierch skin graft (Group A; 14 (51.8%)) versus myocutaneous flap (Group B; 13 (48.2%) cases),either medial or lateral head. Postoperative follow up was for 6 months. Results: Rapid healing of tibial fracture was noticed in 8 (57.1%) cases of group A & another 8 (61.5%) cases of group B within 2 weeks after surgery & there was no flap loss apart from partial skin loss, minor hematomas or infections; All were noticed significantly more in group A; 5 (35.7%), 6 (42.9%), 4 (28.6%) cases; But in group B; one case (8%), 2 (15.4%), one case (8%) respectively (P-Value