The peroneus brevis muscle flap for lower leg defects.

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Vascular Anatomy

Background:

• The peroneus brevis muscle, with its Type II vascular pattern, is located in the leg's lateral compartment.
• It receives blood supply from the peroneal artery and extends to the lateral malleolus.
• This anatomical feature allows for its potential use as a flap for distal leg reconstruction.

Purpose of the Study:

• To evaluate the efficacy of the peroneus brevis flap with split-thickness skin grafts.
• To assess its utility in covering defects in the distal third of the leg, specifically lateral malleolar fractures with exposed hardware or bone.
• To report on one case of covering an exposed Achilles' tendon.

Main Methods:

• Eight peroneus brevis flaps covered with split-thickness skin grafts were used.
• The flaps were employed to reconstruct defects in the distal third of the leg.
• One additional case involved coverage of an exposed Achilles' tendon.

Main Results:

• Seven out of eight peroneus brevis flaps were successful in wound coverage.
• One flap in a diabetic patient experienced partial necrosis, necessitating a secondary fasciocutaneous flap.
• The procedure demonstrated utility for complex wounds in the distal leg.

Conclusions:

• The peroneus brevis flap is a viable option for reconstructing small distal third leg defects.
• It is particularly useful for challenging wounds, such as those involving exposed hardware in lateral malleolar fractures.
• While generally successful, patient comorbidities like diabetes may influence outcomes.