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-
1
Huang MD, Valderrabano V, Reiger UM, et al: Anatomically and biomechanically based algorithm for foot and ankle soft tissue reconstruction. .Handchir Mikrochir Plast Chi 40::377. ,2008. .
-
2
Schweinberger MH, Roukis TS: Wound complications. .Clin Podiatr Med Surg 26::1. ,2009. .
-
3
McGregor IA, Morgan G: Axial and random pattern flaps. .Br J Plast Surg 16::202. ,1973. .
-
4
Roukis TS: The Doppler probe for planning septofasciocutaneous advancement flaps on the plantar aspect of the foot: anatomical study and clinical applications. .J Foot Ankle Surg 39::270. ,2000. .
-
5
Masquelet AC, Gilbert A: “Vascular Anatomy: Vascularization of the Skin of the Limbs and Classification of Skin Flaps,” in An Atlas of Flaps in Limb Reconstruction, ed by AC Masquelet, A Gilbert, p 9, JB Lippincott, Philadelphia. ,1995. .
-
6
Clark N, Sherman R: Soft tissue reconstruction of the foot and ankle. .Orthop Clin North Am 24::489. ,1993. .
-
7
Masquelet AC, Romana MC, Wolf G: Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: anatomic study and clinical experience in the leg. .Plast Reconstr Surg 89::1115. ,1992. .
-
8
Mueller JE, Ilchmann T, Lowatascheff T: The musculocutaneous sural artery flap for soft-tissue coverage after calcaneal fracture. .Arch Orthop Trauma Surg 121::350. ,2001. .
-
9
Chen S, Chen T, Chuo T, et al: Distally based sural fasciomusculocutaneous flap for chronic calcaneal osteomyelitis in diabetic patients. .Ann Plast Surg 54::44. ,2005. .
-
10
Tan O, Atik B, Bekerecioglu M: Supercharged reverse-flow sural flap: a new modification increasing the reliability of the flap. .Microsurgery 25::36. ,2005. .
-
11
Bocchi A, Merelli S, Morellini A, et al: Reverse fasciosubcutaneous flap versus distally pedicled sural island flap: two elective methods for distal-third leg reconstruction. .Ann Plast Surg 45::284. ,2000. .
-
12
Batchelor JS, McGuinness A: A reappraisal of axial and nonaxial lower leg fascial flaps: an anatomic study in human cadavers. .Plast Reconstr Surg 97::993. ,1996. .
-
13
Nakajima H, Imanishi N, Fukuzumi S, et al: Accompanying arteries of the cutaneous veins and cutaneous nerves in the extremities: anatomical study and a concept of the venoadipofascial and/or neuroadipofascial pedicled fasciocutaneous flap. .Plast Reconstr Surg 102::779. ,1998. .
-
14
Nakajima H, Imanishi N, Fukuzumi S, et al: Accompanying arteries of the lesser saphenous vein and sural nerve: anatomic study and its clinical applications. .Plast Reconstr Surg 103::104. ,1999. .
-
15
Le Huec JC, Midy D, Chauveaux D, et al: Anatomic basis of the sural fasciocutaneous flap: surgical applications. .Surg Radiol Anat 10::5. ,1988. .
-
16
Donski PK, Fogdestam I: Distally based fasciocutaneous flap from the sural region: a preliminary report. .Scand J Plast Reconstr Surg 17::191. ,1983. .
-
17
Ponten B: The fasciocutaneous flap: its use in soft tissue defects of the lower leg. .Br J Plast Surg 34::215. ,1981. .
-
18
Townsend PG: An inferiorly based soleus muscle flap. .Br J Plast Surg 31::210. ,1978. .
-
19
Yoshimura M, Imura S, Shimamura K, et al: Peroneal flap for reconstruction in the extremity: preliminary report. .Plast Reconstr Surg 74::402. ,1984. .
-
20
Wee JTK: Reconstruction of the lower leg and foot with the reverse pedicled anterior tibial flap: preliminary report of a new fasciocutaneous flap. .Br J Plast Surg 39::327. ,1986. .
-
21
Goldberg JA, Adkins P, Tsai TM: Microvascular reconstruction of the foot: weight-bearing patterns, gait analysis, and long-term follow-up. .Plast Reconstr Surg 92::904. ,1993. .
-
22
Serafin D, Sabatier RE, Morris RL, et al: Reconstruction of the lower extremity with vascularized composite tissue: improved tissue survival and specific indications. .Plast Reconstr Surg 66::230. ,1980. .
-
23
May JW Jr, Halls M-J, Simon SR: Free microvascular muscle flaps with skin graft reconstruction of extensive defects of the foot: a clinical and gait analysis study. .Plast Reconstr Surg 75::627. ,1985. .
-
24
Danino A-M, Gras M, Coeugniet E, et al: Is muscle the best coverage for leg Gustilo IIIb fractures? a retrospective comparative study [in French]. .Ann Chir Plast Esthet 53::473. ,2008. .
-
25
Baumeister SP, Spierer R, Erdmann D, et al: A realistic complication analysis of 70 sural artery flaps in a multimorbid patient group. .Plast Reconstr Surg 112::129. ,2003. .
-
26
Follmar KE, Baccarani A, Baumeister S-P, et al: The distally based sural flap. .Plast Reconstr Surg 119::138e. ,2007. .
-
27
Jeng S, Hsieh CH, Kuo Y, et al: Distally based sural island flap. .Plast Reconstr Surg 111::840. ,2003. .
-
28
Moutran M, Mojallal A, Chekaroua K, et al: Foot defect with vascular and neural injury due to freshwater stingray sting: reconstruction with a lesser saphenous vein adipofascial flap [in French]. .Ann Chir Plast Esthet 54::156. ,2009. .
-
29
Mojallal A, Wong C, Bailey S, et al: On “Maximizing the reliability and safety of the distally based sural artery flap (J Reconstr Microsurg 2008; 24: 589–594)”. J Reconstr Microsurg 25::391. ,2009. .
-
30
Yang D, Morris SF: Reversed sural island flap supplied by the lower septocutaneous perforator of the peroneal artery. .Ann Plast Surg 49::375. ,2002. .
-
31
Zhang FH, Chang SM, Lin SQ, et al: Modified distally based sural neuro-veno-fasciocutaneous flap: anatomical study and clinical applications. .Microsurgery 25::543. ,2005. .
-
32
Hasegawa M, Torii S, Katoh H, et al: The distally based superficial sural artery flap. .Plast Reconstr Surg 93::1012. ,1994. .
-
33
Hollier L, Sharma S, Babigumira E, et al: Versatility of the sural fasciocutaneous flap in the coverage of lower extremity wounds. .Plast Reconstr Surg 110::1673. ,2002. .
Distally Based Adipofascial Sural Flap for Foot and Ankle Reconstruction
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Background: This retrospective study of a case series analyzed the results from the application of a distally based adipofascial sural flap for nonweightbearing defects of the foot and ankle.
Methods: Twenty-eight patients with post-traumatic ankle and foot defects (ten women and 18 men; age range, 17–63 years) underwent surgery between November 1, 2003, and November 30, 2008. Distally based adipofascial sural flaps were used in ten open fractures, 14 soft-tissue post-traumatic defects, and four deep burns. Defects were on the dorsal side of the foot (eight cases), the lateral malleolus (four cases), the medial malleolus and inframalleolar region (four cases), the Achilles tendon region (eight cases), and the anterior surface of the ankle (four cases). Surgical procedures were performed by a single surgeon (A.M.).
Results: All of the flaps healed uneventfully. There was no partial or total flap loss. All 28 patients walked normally at the time of follow-up. Three delayed healings occurred at the donor site.
Conclusions: This is a homogeneous series of lower-limb reconstructions with the distally based adipofascial sural flap, which permits better analysis of the results. This flap has a constant and reliable blood supply. It can be used for the reconstruction of nonweightbearing foot and ankle regions to avoid the bulky volume of the fasciocutaneous flap in this area and to minimize the donor site scar. (J Am Podiatr Med Assoc 101(1): 41–48, 2011)
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