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Donor Site Morbidity Assessment Using Elastography Following Peroneal Artery-Based Flap Harvest: A Pilot Study
Ying-Sheng Lin1,2, Chih-Chien Hung3
1Division of Plastic and Reconstructive Surgery, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan.
Microsurgery
|October 29, 2025
Summary
Peroneal artery-based flap harvest showed increased soleus muscle stiffness but no significant functional impairment at the donor site six months postoperatively. This study used elastography to assess muscle stiffness changes following reconstructive surgery.
Area of Science:
- Reconstructive Surgery
- Musculoskeletal Imaging
- Biomaterials Science
Background:
- Peroneal artery-based free flaps (fibula and peroneal flaps) are vital in reconstructive surgery.
- Donor site morbidity is a significant concern with these flap harvests.
- Elastography offers a non-invasive method to quantify soft tissue elasticity.
Purpose of the Study:
- To evaluate muscle stiffness changes at peroneal artery flap donor sites using elastography.
- To correlate objective stiffness measurements with functional outcomes.
Main Methods:
- Nine patients undergoing peroneal artery-based flap reconstruction were assessed.
- Elastography and American Orthopedic Foot and Ankle Society (AOFAS) scores were used for donor site evaluation.
- Measurements were taken preoperatively and at 1, 3, and 6 months postoperatively.
Main Results:
- Soleus muscle stiffness significantly increased at 6 months postoperatively (p=0.04).
- No significant differences were found in AOFAS functional scores between preoperative and 6-month postoperative assessments.
- Six out of nine patients completed all follow-up evaluations.
Conclusions:
- Peroneal artery-based flap harvest leads to increased soleus muscle stiffness.
- Despite stiffness changes, no clinically significant functional impairment was observed at the donor site six months postoperatively.
- Elastography can detect objective changes in muscle stiffness following flap harvest.
