A Three-step Algorithm for Axial Pattern Flap Selection in Repairing Deep Soft Tissue Defects of the Lower Extremity

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Deep lower extremity defects often involve critical structures like bone, tendons, or joint cavities.
• Effective reconstruction requires precise flap selection for optimal outcomes.

Purpose of the Study:

• To present and evaluate a novel three-step algorithm for axial pattern flap selection in lower extremity reconstruction.
• To assess the efficacy and safety of this algorithm in patients with complex defects.

Main Methods:

• Retrospective review of 96 patients undergoing axial pattern flap repair for deep lower extremity defects (Jan 2007-Dec 2023).
• Development and application of a three-step algorithm based on defect location, size, and vascularity of potential flaps.
• Evaluation of outcomes including flap survival, functional recovery (Lower Extremity Functional Scale), complications, and patient satisfaction.

Main Results:

• The algorithm was applied to 96 patients (mean age 51.2 years).
• Achieved a 100% flap survival rate with no severe complications.
• Demonstrated excellent functional recovery (mean LEFS 65.6) and high patient satisfaction (85.4%).

Conclusions:

• The three-step algorithm provides a practical and straightforward approach for axial pattern flap selection.
• This method leads to satisfactory long-term outcomes in the repair of deep lower extremity defects.
• The algorithm is a valuable tool for reconstructive surgeons managing complex limb injuries.