title: Distally based sural neurocutaneous flaps for ankle and heel ulcers.
abstract: This study assessed the use of sural neurocutaneous flaps to repair chronic ulcers in difficult-to-cover areas around the ankle and heel. Follow-up of the 14 patients included in this study ranged from 6 months to 3 years after their operation. Total flap loss occurred in two patients, both of whom had rheumatoid arthritis complicated by vasculitis. Partial flap loss occurred in three patients; all were heel ulcers. Additional skin grafting procedures were required to cover their ulcers. A lateral malleolus ulcer in a patient with rheumatoid arthritis recurred after 1 year and had to be covered with a free parascapular flap. The sural neurocutaneous flap is thus a reliable means of resurfacing ulcers in the ankle and heel region. It requires no sacrifice of major peripheral vessels and may be a useful alternative for patients with poor peripheral pulses. Its use in the presence of vasculitis, however, needs further refinement.
authors.affiliation: Department of Orthopaedics and Traumatology, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong.
authors.forename: K H
authors.initials: KH
authors.lastname: Mak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000601:surgery*; D006365:Heel / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000294:innervation