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The split peroneus muscle flap: a new flap for lower leg defects
1Plastic and Reconstructive Surgery, Hamad Medical Corporation, Al-Omran Street, Doha, Qatar. hamdyel@yahoo.com
Summary
A novel split peroneus brevis muscle flap effectively covers fibular and pretibial defects after ankle fractures. This technique preserves muscle function and achieves stable wound healing with good cosmetic results.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Peroneus brevis tendon is crucial for foot and ankle biomechanics.
- Open ankle fractures with exposed hardware present significant reconstructive challenges.
- Existing methods for soft tissue coverage may compromise muscle function.
Observation:
- A longitudinal vertical split of the peroneus brevis muscle was developed as a flap.
- This technique allows transposition without disinsertion, preserving muscle continuity.
- The flap was tested on seven male patients with open ankle fractures and exposed fibular implants.
Findings:
- The split peroneus muscle flap successfully covered soft tissue defects ranging from 13x6cm to 15x7cm.
- All patients achieved stable wound healing with no flap necrosis.
- Muscle function and cosmetic outcomes were preserved post-operatively.
Implications:
- This technique offers a simple, reliable method for reconstructing fibular and pretibial defects.
- It allows for coverage of larger defects (up to 20x7cm) while maintaining muscle function.
- The flap's preservation facilitates potential future reconstructive procedures.
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