[Clinical categorization and microsurgical reconstruction strategies for complex foot-ankle tissue defects]

The foot and ankle have a special anatomical structure and bear crucial functions of body such as weight bearing, walking, running, and jumping. High-energy injuries to these areas are complex, posing challenges to clinical tissue reconstruction. Complex foot-ankle tissue defects mostly present as multicompartmental defects involving skin and soft tissue, tendons, bones, and joints, as well as large-area skin and soft tissue defects. We divided the foot and ankle into nine regions based on the anatomical characteristics and physiological functions of different sites. Ten clinical types were then classified according to the involved regions of tissue defects and the presence of combined deep tissue defects. For each clinical type, appropriate flap donor sites and suitable special form of perforator flap procedures can be selected based on the requirements of microsurgical reconstruction to achieve personalized and precise reconstruction, so as to achieve the optimal restoration of the appearance and function of the foot and ankle with minimal donor-site damage.