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Objective To discuss the clinical effects of forward lateral malleolus perforator flap in the repair of skin and soft tissue defect of ankle or dorsal foot.Methods From November,2014 to June,2017,16 cases of skin and soft tissue defect in ankle or dorsal foot had been repaired,which were 11 males and 5 females,aged from 25to 58 years old(average,32.5 years).The rotation points were on proximal 5 cm of the lateral malleolus in 11 cases and on the level of tarsal sinus in 5 cases.The largest flap was 10.0 cm×18.0 cm and the smallest flap was 6.0 cm×4.0 cm.The color,thickness,texture,sensation,appearance,donor site shape and functional were followed-up after operation.Results All the 16 patients were followed-up from 1 to 24 months.The distal flap appeared dark in 1 case 2 days after operation,and blood supply was improved after stitches;One case was superficial necrosis and healed after dressing.All the flaps had good appearance and texture,no pigmentation,scar contracture,and so on.Conclusion The forward lateral malleolus perforator flaps have perforator constantly and the color,thickness are similar with the receiving areas,the rotation point could on proximal 5 cm of the lateral malleolus and on the level of tarsal sinus,which is a good method to repair skin and soft tissue defect of ankle or dorsal foot.
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Objective To summarize clinical experience of application of muliplefoliated flap combined with tendon graft from dorsal foot for repairing soft tissue defects of multi-fingers. Methods Based on the results of microdissection researches, muliplefoliated flap including medial foot flap, the first metatarsal dorsal flap, lateral foot flap, extensor pollicis brevis of toe and extensor proprius of the fifth toe pedicled by anterior tibial vessels and dorsal pedis vessels as trunk, anterior medial malleolus vessels, the first metatarsal vessels and anterior lateral malleolus vessels as branches respective was designed for repairing soft tissue and tendon defects of multi-fingers. Results In all 12 cases, total survival of flap was 11 cases , 1 case had partial necrosis of distal flap and it was healed by dress changing. Conclusion Transplantation of muliplefoliated flap combined with tendon graft from dorsal foot is a good method to repair soft tissue and tendon defects of multi-fingers.
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Objective:To study the anatomic and clinical experience in distally based neuroadipofascial turnover flap incorporating superficial peroneal nerve.Methods:Thirty six (32 preserved and 4 fresh) cadaver lower limbs were used to investigate the blood supply of superficial peroneal nerve and the relationship with the vascularization of its vicinity integument.Distally based neuroadipofascial flap incorporating the nutrifying vessels of superficial peroneal nerve was designed for dorsal foot reconstruction.Results:The proximal part of superficial peroneal nerve was supplied by an accompanying superficial peroneal artery.In the one third part of the lower leg,this artery became an interlacing paraneural vascular plexus and was reinforced by branches from the distal perforators of anterior tibial artery,the supramalleolar perforator of peroneal artery,and the recurrent branches of dorsal pedal artery.Two chain linked longitudinal vascular plexuses (fascial and paraneural) were confirmed in the anterior lower leg integument.In practice,distally based superficial peroneal neuroadipofascial turnover flaps were successfully transferred in 5 cases.The flap measured (10 14) cm?(4 5) cm in size.The pedicle was (3 4) cm in width.The pivot point was located (2 3) cm above the line between medial and lateral malleolus.Conclusion:Distally based superficial peroneal neuroadipofascial turnover flap is a simple and safe procedure with minimal morbidity of the donor site.