title: Clinical application of the distally based medial adipofascial flap for soft tissue defects on the lower half of the leg.
abstract: OBJECTIVE
  Reconstruction of soft tissue defects on the lower half of the leg.
  
  
  METHODS
  The distally based medial adipofascial flap nourished by the lower perforator originating from the posterior tibial artery was harvested, and the pivot point of flap transposition is 9 to 12 cm above the tip of the medial malleolus.
  
  
  METHODS
  Twelve cases of open tibial fracture associated with soft tissue defects on the lower half of the leg were reconstructed with this flap. The cases consisted of ten males and two females, and their ages ranged from 16 to 71 (averaging 41 years).
  
  
  RESULTS
  Size of the flap varied from 4 x 7 cm to 5 x 18 cm. Eleven flaps had good perfusion and survived completely. Tip necrosis of the flap occurred in one case. In the early postoperative period, take of the meshed split-thickness skin graft on the flap was not complete. All wounds, however, were resurfaced completely without the need of a second grafting. Discharging sinuses occurred in one case, which was managed by removal of infected bony fragments. All the donor sites were closed primarily, and desquamation of wound edges occurred occasionally.
  
  
  CONCLUSIONS
  The distally based medial adipofascial flap was a reliable and effect local flap for the reconstruction of soft tissue defects on the lower half of the leg.
authors.affiliation: Department of Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical College, Taiwan.
authors.forename: S D
authors.initials: SD
authors.lastname: Lin
authors.forename: C S
authors.initials: CS
authors.lastname: Lai
authors.forename: C C
authors.initials: CC
authors.lastname: Tsai
authors.forename: C K
authors.initials: CK
authors.lastname: Chou
authors.forename: C W
authors.initials: CW
authors.lastname: Tsai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005597:Fractures, Open / Q000150:complications; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000209:etiology / Q000601:surgery; D013524:Surgical Flaps / Q000379:methods*; D013978:Tibial Fractures / Q000150:complications; D016896:Treatment Outcome