title: [Soft tissue reconstruction of the distal lower extremity using the 180-degree perforator-based propeller flap].
abstract: OBJECTIVE
  Operative technique of propeller flap reconstruction of soft tissue defects in the distal lower extremity. Soft tissue reconstruction of the distal third of the lower extremity with local, reliable perforator flaps avoiding free tissue transfer.
  
  
  METHODS
  Complex wounds (maximum width of 6 cm) of the distal lower extremity with exposed bones, joints, tendons, and neurovascular structures.
  
  
  METHODS
  Arterial vascular disease (stage III or IV), diabetes mellitus, postthrombotic syndrome, venous ulcers, chronic lymphedema, contusion of adjacent soft tissue, previous radiation, and lack of perforators
  
  
  METHODS
  The perforator represents the pivot point around which rotation of up to 180º of the subfascially harvested flap allows closure of the defect. The proximal donor site can be closed primarily up to a width of 6 cm.
  
  
  METHODS
  Strict elevation of the extremity for 5 days, then flap conditioning.
  
  
  RESULTS
  This technique was used for soft tissue reconstruction in 17 patients. In one patient with diabetes, complete flap necrosis occurred, requiring amputation of the extremity. One case of epidermolysis healed without further surgery.
authors.affiliation: Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Uniklinikum Würzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Deutschland. Jakubietz_R@chirurgie.uni-wuerzburg.de
authors.forename: R G
authors.initials: RG
authors.lastname: Jakubietz
authors.forename: K
authors.initials: K
authors.lastname: Schmidt
authors.forename: B M
authors.initials: BM
authors.lastname: Holzapfel
authors.forename: R H
authors.initials: RH
authors.lastname: Meffert
authors.forename: M
authors.initials: M
authors.lastname: Rudert
authors.forename: M G
authors.initials: MG
authors.lastname: Jakubietz
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000601:surgery; D005096:Exostoses / Q000601:surgery; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*