title: The proximally based long peroneal muscle turnover flap: A novel salvage flap for small to medium-sized defects of the knee.
abstract: OBJECTIVE
  Coverage of soft-tissue defects of the knee due to multiple operations, trauma, and infection remains a surgical challenge. Often, these defects are repaired using free tissue transfer. The aim of this study was to find an easy and reliable local method of repair for small to medium-sized defects. The authors describe a new surgical option for tissue coverage using a proximally based long peroneal muscle turnover flap (LPTF) with split-thickness skin graft.
  
  
  METHODS
  Proximally based LPTFs were harvested and transposed into same-size created defects in five cadavers. After optimizing this technique, it was clinically used in two patients with defects secondary to total knee replacement revisions.
  
  
  RESULTS
  Average cadaver flap size was 4.7 × 15.8 cm allowing reach of all knee joint areas and was based consistently on a sufficient (2-mm-diameter average) proximal arterial branch of the anterior tibial artery. Donor sites were closed without tension. Subsequent application of the flap on two patients resulted in good functional outcome.
  
  
  CONCLUSIONS
  The proximally based LPTF is a new option available in the reconstruction of knee defects and should be added to the reconstructive surgeon's armamentarium of pedicled flaps, providing short operating time and promising clinical outcome.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Radboud University Medical Center Nijmegen (Radboudumc), Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: till.wagner@radboudumc.nl.
authors.forename: Till
authors.initials: T
authors.lastname: Wagner
authors.affiliation: Department of Plastic and Reconstructive Surgery, Radboud University Medical Center Nijmegen (Radboudumc), Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Hupkens
authors.affiliation: Department of Plastic and Reconstructive Surgery, Radboud University Medical Center Nijmegen (Radboudumc), Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Slater
authors.affiliation: Department of Plastic and Reconstructive Surgery, Radboud University Medical Center Nijmegen (Radboudumc), Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Dietmar J O
authors.initials: DJ
authors.lastname: Ulrich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation*; D016879:Salvage Therapy; D016038:Skin Transplantation; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: Knee defects; Knee implant cover; Locoregional muscle flap; Salvage flap