Chinese Journal of Reparative and Reconstructive Surgery
Supervisor： National Health Commission of the People's Republic of ChinaSponsor： Chinese Association of Rehabilitation Medicine , Sichuan University Editor-in-chief：Bin Shen Publishing period：
Monthly
ISSN：1002-1892CN：51-1372/R
Objective To explore the feasibility and effectiveness of V-Y advanced sense-remained posterior tibial artery perforator flap in repairing wound around the ankle.
Methods Between March 2012 and January 2015, 11 patients with wounds around the ankle were treated by V-Y advanced sense-remained posterior tibial artery perforator flap. There were 6 males and 5 females with a median age of 37 years (range, 21-56 years). The causes were traffic accident injury in 3 cases, thermal injury in 2 cases, burn in 2 cases, iatrogenic wounds in 2 cases, and local contusion in 2 cases. The disease duration ranged from 1 to 3 weeks (mean, 2 weeks). Injury was located at the medial malleolus in 4 cases, at the lateral malleolus in 3 cases, and at the heel in 4 cases. All had exposure of bone, tendon, or plate. The defect area ranged from 4 cm×2 cm to 5 cm×3 cm; the area of the flap ranged from 11 cm×4 cm to 15 cm×6 cm.
Results Necrosis of distal flap occurred in 1 case after operation; re-operation to amputate the posterior tibial artery was given and the wound was repaired by proximal skin graft. Light necrosis of distal end was observed in 2 cases, and wound healed at 3 weeks after dressing. And other flaps successfully survived, and primary healing of wounds were obtained. The patients were followed up 6-24 months (mean, 11 months). The flaps were good in color, texture, and appearance. The ankle joint had normal activity. At last follow-up, 10 cases restored fine sense, and 1 case restored protective feeling with posterior tibial artery advanced flap after amputation.
Conclusion V-Y advanced sense-remained posterior tibial artery perforator flap has the advantages of reliable blood supply, simple operation, good appearance, and sensory recovery. Therefore, it is an ideal method to repair wound around the ankle.
Citation：TANGXiujun, WANGBo, WEIZairong, WANGDali, HANWenjie, ZHANGWenduo, LIShujun. APPLICATION OF V-Y ADVANCED SENSE-REMAINED POSTERIOR TIBIAL ARTERY PERFORATOR FLAP IN REPAIRING WOUND AROUND ANKLE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(12): 1515-1518. doi: 10.7507/1002-1892.20150324Copy
Copyright ? the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
Haddock NT, Wapner K, Levin LS. Vascular bone transfer options in the foot and ankle:a retrospective review and update on strategies. Plast Reconstr Surg, 2013, 132(3):685-693.
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Tan O, Aydin OE, Demir R, et al. Neurotized sural flap:An alternative in sensory reconstruction of the foot and ankle defects. Microsurgery, 2015, 35(3):183-189.
6. Haddock NT, Wapner K, Levin LS. Vascular bone transfer options in the foot and ankle:a retrospective review and update on strategies. Plast Reconstr Surg, 2013, 132(3):685-693.
7. Akita S, Mitsukawa N, Rikihisa N, et al. Descending branch of the perforating branch of the peroneal artery perforator-based island flap for reconstruction of the lateral malleolus with minimal invasion. Plast Reconstr Surg, 2013, 132(2):461-469.
14. Tan O, Aydin OE, Demir R, et al. Neurotized sural flap:An alternative in sensory reconstruction of the foot and ankle defects. Microsurgery, 2015, 35(3):183-189.
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