title: Anatomical study of terminal peroneal artery perforators and their clinical applications.
abstract: BACKGROUND
  Peroneal artery gives off plenty of perforators that pass through fascial septum to supply skin and tenosynovium of peroneal muscles.
  
  
  OBJECTIVE
  The aim of this study was to study the anatomical basis of perforators from terminal part of peroneal artery axiality and to make use of this knowledge in reconstructing defects of posterior heel with the advantage of reducing the morbidity of conventional flaps.
  
  
  METHODS
  Our study was conducted at Department of Plastic surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, India. We have carried out eleven cadaver dissections (from six cadavers-four fresh cadavers and two preserved cadavers) and delineated all septocutaneous and septosynovial perforators of distal peroneal axis and studied their relation with short saphenous vein (SSV) and sural nerve. Using this anatomical knowledge we have fashioned perforator based flaps in 13 patients (three propeller, four V-Y advancement, six tenosynovial flaps) for reconstruction of defects over tendo achilles and pericalcaneal region.
  
  
  RESULTS
  In all cases, SSV and sural nerve were preserved and donor site was closed primarily. No total flap loss was noted.
  
  
  CONCLUSIONS
  Perforator based flaps from distal most part of peroneal artery provide a good and reliable method for reconstruction of pericalcaneal and tendo achilles region defects with preservation of SSV and sural nerve. It also avoids contour deformity of the grafted donor site of the classical lateral calcaneal artery axial flap.
authors: Department of Plastic, Reconstructive and Faciomaxillary Surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.
authors: Rajendran
authors: R
authors: Purushothaman
authors: T M
authors: TM
authors: Balakrishnan
authors: K V
authors: KV
authors: Alalasundaram
keywords: Terminal peroneal artery; V-Y advancement; lateral calcaneal artery; perforator-based flaps; peroneal tenosynovial sheath; propeller
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