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Nerve sparing-distally based sural flap.

Osman E Aydin1, Onder Tan, Selma D Kuduban

  • 1Department of Plastic Reconstructive and Aesthetic Surgery, Ataturk University, Medical Faculty, Erzurum, Turkey. enveraydin@yahoo.com

Microsurgery
|April 28, 2011
PubMed
Summary

Preserving the sural nerve in distally based sural flaps for ankle and foot reconstruction prevents donor site paresthesia. This nerve-sparing technique maintains flap circulation and promotes successful soft-tissue defect management.

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Area of Science:

  • Orthopedic Surgery
  • Plastic Surgery
  • Reconstructive Surgery

Background:

  • Managing soft-tissue defects in the ankle and foot presents significant challenges.
  • The distally based sural flap is a common technique, but it can result in donor site paresthesia.

Purpose of the Study:

  • To evaluate the safety and efficacy of a modified distally based sural flap that preserves the sural nerve for ankle and foot soft-tissue reconstruction.

Main Methods:

  • The sural nerve was dissected and preserved within the distally based sural flap in five reconstructive cases.
  • Flap circulation was monitored post-operatively.
  • Outcomes including flap survival and donor site sensation were assessed.

Main Results:

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  • All elevated flaps survived, with one instance of partial distal necrosis.
  • Preserving the sural nerve did not compromise flap circulation.
  • The technique allowed for elevation with a narrow subcutaneous pedicle (3-4 cm).
  • Conclusions:

    • The distally based nerve-sparing sural flap is a viable and secure option for ankle and foot soft-tissue reconstruction.
    • This modification effectively avoids donor site paresthesia without compromising flap viability.