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Pedicled Peroneus Brevis Muscle Flaps as an Alternative to Fasciocutaneous Rotational Flaps for Lower-Extremity Soft
Merlin Antúnez1, Cormac Huyen1, Rafael Neiman1,2
1Holy Family Surgery Center, One World Surgery, Tegucigalpa, Honduras; and.
Journal of Orthopaedic Trauma
|December 30, 2023
Summary
The peroneus brevis flap (PBF) is effective for soft tissue defects in the lower leg, ankle, and hindfoot, even in resource-limited settings. This muscle flap provides reliable coverage without complex microvascular surgery.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Soft tissue defects in the distal tibia, ankle, and hindfoot present significant reconstructive challenges.
- Resource-limited environments often lack access to advanced reconstructive techniques like free tissue transfer.
Purpose of the Study:
- To evaluate the efficacy of the peroneus brevis flap (PBF) for soft tissue coverage in challenging anatomical locations.
- To assess the feasibility of using PBF in resource-constrained settings.
Main Methods:
- Retrospective review of 23 patients treated with proximally or distally based pedicled PBF.
- Study conducted in a rural outpatient surgical facility in Honduras.
- Outcomes assessed included flap healing, complications, and reoperations.
Main Results:
- The PBF successfully covered defects in 21 out of 23 patients.
- 30% of flaps required split-thickness skin grafting; the rest granulated successfully.
- One flap was lost completely, and four required partial debridement; donor sites healed without complications.
Conclusions:
- The pedicled peroneus brevis flap is a viable option for coverage of distal leg, ankle, and hindfoot wounds.
- PBF can be performed without microvascular expertise, making it suitable for resource-challenged areas.
