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The lateral supramalleolar flap: experience with 41 flaps.
Philippe Voche1, Michel Merle, Jean-David Stussi
1European Institute for Hand Surgery, Maxeville, France. pvoche@libertysurf.fr
Annals of Plastic Surgery
|December 23, 2004
Summary
The lateral supramalleolar flap effectively reconstructs defects in the lower leg, ankle, and foot. While venous congestion occurred, it offered good functional and acceptable cosmetic outcomes with minimal donor site morbidity.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
Background:
- Reconstruction of distal third leg, foot, ankle, and heel defects presents challenges.
- The lateral supramalleolar flap is a reconstructive option for these complex injuries.
Purpose of the Study:
- To evaluate the efficacy and outcomes of the lateral supramalleolar flap in reconstructing lower extremity defects.
- To compare its results with the distally based sural flap.
Main Methods:
- Retrospective analysis of 41 cases using the lateral supramalleolar flap.
- Assessment of flap viability, venous congestion, necrosis, and functional/cosmetic outcomes.
- Comparison with the distally based sural flap.
Main Results:
- The flap demonstrated successful arterial supply (mixed or retrograde) in all cases.
- Eight cases of venous congestion occurred, with 3 resulting in partial flap necrosis.
- Functional results were satisfactory in most patients, but cosmetic outcomes were less consistently satisfactory.
- Donor site morbidity was minimal.
Conclusions:
- The lateral supramalleolar flap is a viable option for distal lower extremity reconstruction, with recommendations for raising a distal subcutaneous pedicle.
- It offers advantages over the distally based sural flap in terms of distal coverage and nerve sparing.
- While functional outcomes are generally good, cosmetic results require further consideration.