Heel and foot reconstruction using reverse-flow posterior tibial flap

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Vascular Surgery

Background:

• Island flaps utilizing intermuscular cutaneous perforators (IMCPs) from deep vessels are established for lower leg soft-tissue defects.
• While peroneal and anterior tibial flaps are described, the posterior tibial flap's utility remains less documented.

Purpose of the Study:

• To describe the posterior tibial flap pedicled by IMCP from the posterior tibial vessel.
• To evaluate its application, particularly as a reverse-flow flap, for heel and foot defect reconstruction.

Main Methods:

• The study describes the operative procedure for the posterior tibial flap.
• Clinical application of three reverse-flow posterior tibial flaps for heel and foot defects was performed.
• The flaps were supplied by IMCPs from the posterior tibial vessel without venous anastomosis.

Main Results:

• All three clinically applied reverse-flow posterior tibial flaps survived completely.
• The posterior tibial flap demonstrated versatility in reconstructing complex heel and foot defects.
• No venous anastomosis was required for successful flap survival.

Conclusions:

• The reverse-flow posterior tibial flap is a viable and effective option for reconstructing soft-tissue defects of the heel and foot.
• This flap provides a valuable alternative in reconstructive surgery, leveraging IMCPs from the posterior tibial vessel.
• Further description and clinical application support its role in specialized reconstructive procedures.