Imaging Study of Peroneal Artery Branches and its Application in Flap Design and Transplantation

The reconstruction of defects in the lower extremity with bone or tendon exposure presents a significant challenge in clinical practice. Among the various surgical options available, the peroneal artery perforator flap (PAPF) stands out as a superior choice for repairing such defects. However, due to potential damage and variations in the peroneal artery's branches and perforators, identifying these anatomic features accurately is crucial for optimizing flap design and transplantation. This study reports the successful experience of reconstructing soft tissue defects of the lower extremity using PAPF. Preoperative digital subtraction angiography (DSA) was used to visualize the peroneal artery and its branches. High-frequency ultrasound was also employed to accurately locate perforating branches. This approach enables visualization, customization, and precision in flap surgery, assisting in flap design and transplantation.