[Imaging study and clinical application of peroneal perforating chimeric tissue flap]

Area of Science:

• Orthopedic Surgery
• Vascular Surgery
• Reconstructive Surgery

Background:

• Composite defects of the calf and heel pose significant reconstructive challenges.
• Effective tissue flaps are crucial for restoring function and form in lower limb injuries.

Purpose of the Study:

• To assess the feasibility and clinical efficacy of the peroneal perforating chimeric tissue flap for composite calf and heel defect repair.
• To analyze the anatomical distribution of peroneal artery perforators using lower limb angiography.

Main Methods:

• Lower limb digital subtraction angiography was performed on 50 patients to map peroneal artery perforator anatomy.
• The peroneal perforating chimeric tissue flap was designed and applied to repair 7 cases of composite calf and heel defects (April 2015-October 2020).
• Flap survival, wound healing, and functional outcomes were evaluated postoperatively.

Main Results:

• Peroneal artery perforators showed consistent anatomical distribution, primarily in four specific locations.
• All 7 peroneal perforating chimeric tissue flaps survived, with complete wound healing by first intention.
• Bone graft healing was successful (6-11 months), with good functional recovery (Holden walking function score grade IV-V in all patients).

Conclusions:

• The peroneal perforating vessel anatomy is predictable, supporting the use of this flap.
• The peroneal perforating chimeric tissue flap is a safe, reliable, and effective method for reconstructing composite calf and heel defects.