Arch Hand Microsurg.  2023 Sep;28(3):188-193. 10.12790/ahm.23.0020.

The outcomes of peroneal artery perforator-based propeller flaps for the treatment of infected lateral malleolar bursitis

• Lee T
• Kim J
• Jeong W
• Jo T
• Park S
• Choi J

• KMID: 2545529
• DOI: http://doi.org/10.12790/ahm.23.0020

Abstract

Purpose
Infected malleolar bursitis sometimes requires multiple debridements, followed by soft tissue reconstruction with a flap. The purpose of this study was to evaluate the clinical outcomes of patients with infected lateral malleolar bursitis who were treated using peroneal artery perforator-based propeller flaps.
Methods
We retrospectively included 10 patients who underwent reconstruction of the lateral malleolus with a peroneal artery perforator-based propeller flap due to infected lateral malleolar bursitis between 2014 and 2022.
Results
The average follow-up time was 77.2 weeks. Six patients experienced complete healing; three developed partial flap necrosis, and one had a long-lasting seroma. All patients with complications had long-term diabetes.
Conclusion
Partial flap necrosis in patients with diabetes may occur because of impaired microcirculation. A peroneal artery perforator-based propeller flap could be useful for soft tissue reconstruction in select patients without diabetes or in patients with diabetes who have infected lateral malleolar bursitis.

Keyword

Infected lateral malleolar bursitis; Peroneal artery perforator-based propeller flap; Diabetes mellitus; Impaired microcirculation

Figure

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  Fig. 1. A 73-year-old man with a 1×3 cm chronic wound on the lateral malleolus due to infective bursitis underwent treatment with a peroneal artery perforator-based propeller flap (A). (B) An intraoperative view. The arrowhead indicates the peroneal artery perforator. (C) Ten weeks postoperative.

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  Fig. 2. A 59-year-old man with a 3×2 cm chronic wound on the lateral malleolus due to infective bursitis underwent treatment with a peroneal artery perforator-based propeller flap (A). (B) Four weeks postoperative.

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  Fig. 3. A 66-year-old man with a 3×2 cm chronic wound on the lateral malleolus due to infective bursitis underwent treatment with a peroneal artery perforator-based propeller flap (A). (B) Intraoperative view. (C) Three weeks postoperative: the necrotic process had progressed in the distal part of the flap.

Reference

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