title: Posterior tibial artery flap in poliomyelitis patients with lower extremity paralysis.
abstract: BACKGROUND
  Poliomyelitis is a disease that can render affected individuals incapacitated to a variable degree. A normal lifespan is expected and therefore the patients deserve every effort at curative cancer resection and reconstruction. Those with lower extremity paralysis rely heavily on their upper limbs and torso for ambulation; therefore, their compromised limbs may be a better donor site for flaps.
  
  
  METHODS
  All poliomyelitis patients with lower extremity paralysis over a 20-month period who underwent head and neck reconstruction were selected for a retrospective review. Perioperative complications were noted and outpatient follow-up was performed.
  
  
  RESULTS
  Three patients underwent reconstruction of defects using the posterior tibial artery flap. Two patients required reconstruction of a buccal defect and one patient required soft palate reconstruction. All patients healed without complications and none required reexploration. At a mean follow-up of 10 months, there was no incidence of donor limb vascular compromise, cold intolerance, or long-term paresthesias.
  
  
  CONCLUSIONS
  The posterior tibial artery free flap has been used successfully in the past; however, its popularity has been limited because of sacrifice of the posterior tibial artery. Nevertheless, in patients with lower extremity paralysis, this flap may fulfill the requirements of a thin, pliable flap with minimal hair that has a long pedicle and a reliable blood supply. Most importantly, the use of this flap obviates the need to use flaps that fulfill the same requirement, such as forearm flaps, that would be taken from patients' functioning limbs.
authors.affiliation: Department of Plastic Surgery, Da Hospital/I-Shou University, Kaohsiung County, Taiwan.
authors.forename: Samir
authors.initials: S
authors.lastname: Mardini
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Salgado
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Chen
authors.forename: Sukru
authors.initials: S
authors.lastname: Yazar
authors.forename: Omer
authors.initials: O
authors.lastname: Ozkan
authors.forename: Paolo
authors.initials: P
authors.lastname: Sassu
mesh_terms: D000328:Adult; D002610:Cheek; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000601:surgery; D010243:Paralysis / Q000453:epidemiology*; D011051:Poliomyelitis / Q000453:epidemiology*; D013524:Surgical Flaps; D016909:Tibial Arteries; D020858:Tissue and Organ Harvesting