Arch Reconstr Microsurg.  2016 Nov;25(2):37-42. 10.15596/ARMS.2016.25.2.37.

Close-by Islanded Posterior Tibial Artery Perforator Flap: For Coverage of the Ankle Defect

• Bahk S
• Hwang S
• Kwon C
• Jeong EC
• Eo SR

• KMID: 2361715
• DOI: http://doi.org/10.15596/ARMS.2016.25.2.37

Abstract

PURPOSE
Soft tissue coverage of the distal leg and ankle region represents a surgical challenge. Beside various local and free flaps, the perforator flap has recently been replaced as a reconstructive choice because of its functional and aesthetic superiority. Although posterior tibial artery perforator flap (PTAPF) has been reported less often than peroneal artery perforator flap, it also provides a reliable surgical option in small to moderate sized defects especially around the medial malleolar region.
MATERIALS AND METHODS
Seven consecutive patients with soft tissue defect in the ankle and foot region were enrolled. After Doppler tracing along the posterior tibial artery, the PTAPF was elevated from the adjacent tissue. The average size of the flap was 28.08±9.31 cm² (range, 14.25 to 37.84 cm²). The elevated flap was acutely rotated or advanced.
RESULTS
Six flaps survived completely but one flap showed partial necrosis because of overprediction of the perforasome. No donor site complications were observed during the follow-up period and all seven patients were satisfied with the final results.
CONCLUSION
For a small to medium-sized defect in the lower leg, we conducted the close-by islanded PTAPF using a single proper adjacent perforator. Considering the weak point of the conventional propeller flap, this technique yields much better aesthetic results as a simple and reliable technique especially for defects of the medial malleolar region.

Keyword

Surgical flaps; Perforator flap; Posterior tibial artery; Ankle

MeSH Terms

Ankle*
Arteries
Follow-Up Studies
Foot
Free Tissue Flaps
Humans
Leg
Necrosis
Perforator Flap*
Surgical Flaps
Tibial Arteries*
Tissue Donors