Lateral calcaneal artery skin flap for posterior heel coverage

The lateral calcaneal artery flap is a neurovascular flap from the lateral side of the calcaneus consisting of the lateral calcaneal artery, sural nerve, and small saphenous vein. It is most useful in coverage of defects over the posterior heel with or without exposure of the tendo Achilles. The donor site is covered with a split-thickness skin graft. Preoperative planning for this flap must include Doppler examination of the course of the artery, as well as documentation of the presence of the other pedal pulses. Disadvantages to use of the flap are the skin depression at the donor site and a loss of two-point discrimination along the dorsolateral foot caused by transfer of the sural nerve.