title: Distally based perforator sural flaps for foot and ankle reconstruction.
abstract: Distally based perforator sural flaps from the posterolateral or posteromedial lower leg aspect are initially a neurofasciocutaneous flap that can be transferred reversely to the foot and ankle region with no need to harvest and sacrifice the deep major artery. These flaps are supplied by a perforating artery issued from the deep peroneal artery or the posterior tibial artery, and the chain-linked adipofascial neurovascular axis around the sural/saphenous nerve. It is a versatile and reliable technique for soft-tissue reconstruction of the heel and ankle region with 180-degrees rotation. In this paper, we present its developing history, vascular basis, surgical techniques including flap design and elevation, flap variations in pedicle and component, surgical indications, and illustrative case reports with different perforating vessels as pivot points for foot and ankle coverage.
authors.affiliation: Shi-Min Chang, Xiao-Hua Li, Department of Orthopedic Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
authors.forename: Shi-Min
authors.initials: SM
authors.lastname: Chang
authors.affiliation: Shi-Min Chang, Xiao-Hua Li, Department of Orthopedic Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Li
authors.affiliation: Shi-Min Chang, Xiao-Hua Li, Department of Orthopedic Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
authors.forename: Yu-Dong
authors.initials: YD
authors.lastname: Gu
keywords: Distally based flap; Fasciocutaneous flap; Foot and ankle; Neurocutaneous flap; Perforator flap; Propeller flap; Sural flap