Arch Reconstr Microsurg.  2015 Nov;24(2):56-61. 10.15596/ARMS.2015.24.2.56.

Diatally-Based Medial Crural Adipofascial Flap for Coverage of Medial Foot and Ankle

Affiliations
  • 1Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea. orthoyhl@snu.ac.kr

Abstract

PURPOSE
We report on the clinical result after coverage of a soft tissue defect on the medial foot and ankle with an adipofascial flap based on the perforator from the posterior tibia artery.
MATERIALS AND METHODS
Nine patients with soft tissue defects on the medial foot and ankle area from March 2009 to May 2014 underwent the procedure. Average age was 54 years old (range, 8~82 years). There were five male patients and four female patients. The causes of the defect were trauma (4), tumor (3), and infection (2). The pivot point of transposition of this flap is the lower perforator originating from the posterior tibia artery. The fatty tissue side of this flap could be used to resurface the defect. The donor site was closed primarily with the preserved skin, and a small caliber drain tube was used. The split-thickness skin graft was grafted to the flap and the wound. If the wound was still infected, this skin graft could be performed at a later date.
RESULTS
All flaps survived and normal soft tissue coverage was obtained for the medial foot and ankle of all patients after the skin graft. Normal footwear was possible for all cases because of thin coverage. There was an extension contracture on the medial ray of the foot, which was resolved by contracture release and skin graft.
CONCLUSIONS
For the medial foot and ankle soft tissue defect, the medial crural adipofascial flap based on a perforator branch of the posterior tibia artery could be a good option to cover it.

Keyword

Soft tissue defect; Medial foot and ankle; Adipofascial flap; Posterior tibia artery; Perforator artery

MeSH Terms

Adipose Tissue
Ankle*
Arteries
Contracture
Female
Foot*
Humans
Male
Skin
Tibia
Tissue Donors
Transplants
Wounds and Injuries
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