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Updated: Jul 3, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Clinical outcomes of the reverse sural flap when performed by orthopaedic trauma surgeons
George A Puneky1, Thomas E Dickerson2, Dhairya Shukla2
1Department of Orthopedic Surgery, Medical College of Georgia at Augusta University, Augusta, GA.
Objectives:
To evaluate reverse sural flap (RSF) outcomes when performed by nonmicrovascular trained orthopaedic trauma surgeons.
Design:
Retrospective cohort.
Setting:
Single level 1 trauma center.
Patients:
Seventeen patients undergoing RSF for soft tissue coverage of distal 1/3rd leg and/or hindfoot wounds. All patients were managed and followed by 2 nonmicrovascular trained orthopaedic surgeons until RSF healing or failure.
Intervention:
Reverse sural flap for coverage of distal leg and/or hindfoot wounds.
Main Outcome Measurements:
RSF survival, percent viability, healing time, and cosmetic outcome. Patient demographic data, comorbidities, and indication for coverage were evaluated in relation to flap survival.
Results:
Flap viability was noted in 14/17 patients, with 3/17 patients experiencing RSF necrosis or failure. Two of three flap failure cases presented with surgical site infection after RSF. The remaining flap failure resulted from an inability to follow weight-bearing restrictions leading to flap shearing and coagulation. Diabetes was present in 2 of 3 flap failure cases. Cosmetic outcomes among the surviving flaps were excellent or good in 12/14 patients, with an average soft tissue healing time of 57.4 days (23-116 days).
Conclusion:
The RSF is a powerful and reliable technique for soft tissue coverage of the distal leg and hindfoot that can be performed without microvascular training.
Level Of Evidence:
Therapeutic Level IV.
