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Modified distally based sural nerve flaps in acute traumatic forefeet reconstructions
Shuang-quan Yao1, Feng-qi Zhang, Jin-she Pan
1Department of Orthopedic, Third Hospital of Hebei Medical University, Shijiazhuang, China.
Annals of Plastic Surgery
|June 24, 2009
Summary
A modified reverse sural artery flap, incorporating a peroneal artery cutaneous branch, effectively reconstructs distal foot defects. This technique prevents flap necrosis, offering a reliable solution for lower leg reconstruction.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Conventional reversed sural flaps are used for lower leg defects.
- Distal marginal necrosis is a common complication in defects of the metatarsophalangeal joint dorsum.
Observation:
- A constant cutaneous branch of the peroneal artery was identified 11.0 +/- 1.7 cm above the lateral malleolus.
- This branch can augment blood supply to distally based reverse sural artery flaps.
Findings:
- Ten modified distally based reverse sural artery flaps were performed for distal foot reconstruction.
- All flaps survived completely, with no instances of distal marginal necrosis.
- The modified flap reliably covers distal-third of the leg defects.
Implications:
- This modified flap is a reliable option for distal foot and lower leg reconstruction when conventional flaps fail.
- It offers a solution to prevent distal marginal necrosis in reverse sural artery flaps.
- The technique has low associated morbidity and high success rates.