title: Posterior tibial artery perforator flaps for coverage of Achilles region defects.
abstract: BACKGROUND
  Defects of the Achilles tendon region still represent a tricky issue in lower limb surgery. Among the several reconstructive possibilities, local propeller perforator flaps have gained popularity in the last decade.
  
  
  METHODS
  We report our experience with eight patients affected by small-to-moderate soft-tissue defects of the Achilles tendon region, who underwent surgical reconstruction with local flaps based on posterior tibial perforator branches.
  
  
  RESULTS
  All patients healed successfully in terms of aesthetic and functional aspect. In only one case a transient venous congestion was observed and this resolved spontaneously.
  
  
  CONCLUSIONS
  Although the surgical technique requires much care and skill, including an extremely gentle dissection of perforator vessels, local propeller flaps should be considered the first-line choice for reconstruction in small-to-medium size soft-tissue defects in the Achilles region.
authors.affiliation: Dipartimento di Chirurgia Plastica Ricostruttiva, I.R.C.C.S. Policlinico San Donato, Università degli Studi di Milano, San Donato Milanese, MI, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Vaienti
authors.affiliation: Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy.
authors.forename: G M
authors.initials: GM
authors.lastname: Calori
authors.affiliation: Dipartimento di Chirurgia Plastica Ricostruttiva, I.R.C.C.S. Policlinico San Donato, Università degli Studi di Milano, San Donato Milanese, MI, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Leone
authors.affiliation: Dipartimento di Chirurgia Plastica Ricostruttiva, I.R.C.C.S. Policlinico San Donato, Università degli Studi di Milano, San Donato Milanese, MI, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Brioschi
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Udine, Udine 33010, Italy.
authors.forename: P C
authors.initials: PC
authors.lastname: Parodi
authors.affiliation: Dipartimento di Chirurgia Plastica Ricostruttiva, I.R.C.C.S. Policlinico San Donato, Università degli Studi di Milano, San Donato Milanese, MI, Italy. Electronic address: ilmarchesiandrea@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Marchesi
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D000328:Adult; D003646:Debridement; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D019651:Plastic Surgery Procedures / Q000379:methods; D017695:Soft Tissue Injuries / Q000601:surgery*; D016909:Tibial Arteries; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome
keywords: Achilles tendon; Ankle; Perforator flap; Soft-tissue reconstruction