title: Modified distally based peroneal artery perforator flap for reconstruction of foot and ankle.
abstract: The distally based sural fasciocutaneous flap has been used widely for reconstruction of foot and ankle soft-tissue defects. Here we report on a series of cases of foot and ankle reconstruction with a modified distally based sural flap. The vascular pedicle of the flap includes an axial perforator branch of the peroneal artery and two concomitant veins. This modified distally based perforator flap, measuring around 17 x 6 cm to 30 x 10 cm in size, was transferred for coverage of foot and ankle soft-tissue defects in 7 cases. All flaps survived completely. Neither arterial ischemia nor venous congestion was noted. As compared to other distally based sural flaps with neuro-veno-adipo-fascial pedicles, this modified sural flap with a thin perforator pedicle is easily rotated. The flap can obtain abundant blood supply through both axial perforator and longitudinal chain-linked vascular plexuses, and does not have the venous reflow problem. In conclusion, the invention of this perforator fasciocutaneous flap provides a valuable tool for repair of foot and ankle soft-tissue defects.
authors.affiliation: Department of Orthopedic Surgery, Tongji University, Tongji Hospital, 389 Xincun Road, Shanghai 200-065, China. shiminchang@yahoo.com.cn
authors.forename: Shi-Min
authors.initials: SM
authors.lastname: Chang
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.forename: Guang-Rong
authors.initials: GR
authors.lastname: Yu
authors.forename: Chun-Lin
authors.initials: CL
authors.lastname: Hou
authors.forename: Yu-Dong
authors.initials: YD
authors.lastname: Gu
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000842:Ankle / Q000601:surgery; D016512:Ankle Injuries / Q000601:surgery*; D001158:Arteries; D002058:Burns, Electric / Q000601:surgery; D005205:Fascia / Q000637:transplantation; D005260:Female; D005360:Fibula / Q000098:blood supply; D005500:Follow-Up Studies; D005528:Foot / Q000601:surgery; D018409:Foot Injuries / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D019651:Plastic Surgery Procedures; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation