Application of the flap pedicled with superior malleolus perforator of anterior tibial artery in reconstruction of soft tissue defects in foot and ankle / 中华显微外科杂志

ABSTRACT

Objective:To explore the clinical effects of the flap pedicled with superior malleolus perforator of anterior tibial artery in reconstruction of the soft defects in foot and ankle.Methods:A retrospective study was carried out to analyze 19 patients with soft tissue defects in foot and ankle. Ninteen patients, which were 11 males and 8 females and aged 21-75 (mean, 39) years, received the surgery between April, 2018 and June, 2019. According to the anatomy of superior malleolus perforating flaps and the size and shape of the soft tissue defects in foot and ankle, flaps were designed and harvested in the anterolateral side of the shank. The sizes of flaps were 6.0 cm×5.0 cm-14.0 cm ×8.0 cm. Evaluation of clinical effects included flap survival, infection control, the elasticity, color, appearance and scars of the donor sites, skin sensations and patient satisfaction. The swelling of flap was also took into an account.Results:All 19 flaps survived after the surgery. The soft tissue defects and exposure of tendon, bone and steel plate were repaired very well. Both the donor and recipient sites healed at stage I. Duration of out-patient clinic followed-up was 2-16 months. All flaps survived very well with good shape, and the color and elasticity were very close to the nearby normal skin. Scars at donor sites were small and the functions of ankle and foot were satisfactory.Conclusion:The flap pedicled with superior malleolus perforator of anterior tibial artery in reconstruction of the soft tissue defect in foot and ankle delivered satisfactory clinical effects. This flap has reliable perforating blood vessels hence reliable blood supply with high survival rate of flaps. It is one of the simple, safe and optimal methods to repair soft tissue defects in foot and ankle.