Anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap for foot and ankle defect_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Wei ¹ , LI Junming ¹ , DAI Pengwei ¹ , ZHANG Xiaoguang ¹ ,  Aihemaitijiang·Yusufu ²

1. Department of Microscopic Orthopedics, the Second Affiliated Hospital, Luohe Medical College, Luohe Henan, 462300, P.R.China;
2. Depantment of Microsurgical and Reconstruction, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054, P.R.China;

Corresponding?author：

Aihemaitijiang·Yusufu, Email: ahmatjang@163.com

Keywords：

Foot and ankle; soft tissue defect; wound repair; anterior tibial artery perforator propeller flap; peroneal artery terminal perforator propeller flap; relaying flap

DOI：

10.7507/1002-1892.201904095

Video：

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Objective To investigate the clinical application of the anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap in repair of foot and ankle defects.Methods Between October 2014 and October 2018, 18 cases with foot and ankle defects were treated. There were 12 males and 6 females with an average age of 32.8 years (range, 8-56 years). There were 11 cases of traffic accident injuries, 3 cases of falling from height injuries, and 4 cases of heavy objects injuries. The wound was at the dorsum of the foot in 9 cases, the heel in 4 cases, the lateral malleolus in 5 cases. The time from injury to flap repair was 7-34 days (mean, 19 days). The size of wound ranged from 6.0 cm×2.5 cm to 11.0 cm×6.0 cm. The foot and ankle defects were repaired with the peroneal artery terminal perforator propeller flap in size of 6 cm×3 cm-18 cm×7 cm, which donor site was repaired with the anterior tibial artery perforator propeller flap in size of 8 cm×3 cm-16 cm×6 cm.Results One patient had a hemorrhagic swelling in the peroneal artery terminal perforator propeller flap, and survived after symptomatic treatment. All recipient and donor sites healed by first intention. Eighteen patients were followed up 6-15 months (mean, 12.5 months). At last follow-up, the shape, color, texture, and thickness of the flaps in the donor sites were similar with those in the recipient sites. There were only linear scars on the donor sites. The two-point discrimination of the peroneal artery terminal perforator propeller flap ranged from 10 to 12 mm (mean, 11 mm). According to American Orthopaedic Foot and Ankle Society (AOFAS) score criteria, the results were excellent in 15 cases and good in 3 cases, with an excellent and good rate of 100%.Conclusion The foot and ankle defects can be repaired with the anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap. The procedure is not sacrificing the main vessel and can avoid the skin grafting and obtain the good ankle function.

Citation： WANG Wei, LI Junming, DAI Pengwei, ZHANG Xiaoguang, Aihemaitijiang·Yusufu. Anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap for foot and ankle defect. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(1): 87-91. doi: 10.7507/1002-1892.201904095 Copy

1.	梁尊鴻, 潘云川, 林師帥. 脛后動脈穿支皮瓣接力修復足踝部及皮瓣供區軟組織缺損. 中華顯微外科雜志, 2018, 41(5): 490-492.
2.	豐波, 張志, 呼和, 等. 小腿穿支皮瓣修復踝周皮膚軟組織缺損. 中華顯微外科雜志, 2014, 37(2): 139-142.
3.	Ducic I, Attinger CE. Foot and ankle reconstruction: pedicled muscle flaps versus free flaps and the role of diabetes. Plast Reconstr Surg, 2011, 128(1): 173-180.
4.	侯春林, 曹誼林, 徐永清. 中國修復重建外科歷史回顧. 中國修復重建外科雜志, 2018, 32(7): 177-180.
5.	潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3): 130-135.
6.	Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
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8.	Lee JH, Chung DW. Reverse lateral supramalleolar adipofascial flap and skin grafting for one-stage soft tissue reconstruction of foot and ankle joint. Microsurgery, 2010, 30(6): 423-429.
9.	金文虎, 常樹森, 魏在榮, 等. 接力逆行腓動脈穿支皮瓣修復足踝部及共瓣區皮膚軟組織缺損. 中華創傷雜志, 2018, 34(7): 624-629.
10.	宋達疆, 李贊, 周曉, 等. 接力腓腸外側動脈穿支螺旋槳皮瓣修復逆行腓腸神經皮瓣供區. 中國修復重建外科雜志, 2017, 31(11): 1363-1366.
11.	王耀軍, 任忠亮, 薛佳杰, 等. 腓動脈穿支接力皮瓣修復脛前中下段及供瓣區皮膚軟組織缺損. 中華整形外科雜志, 2018, 34(12): 1005-1009.
12.	Chi Z, Lin D, Chen Y, et al. Routine closure of the donor site with a second dorsal metacarpal artery flap to avoid the use of a skin graft after harvest of a first dorsal metacarpal artery flap. J Plast Reconstr Aesthet Surg, 2018, 71(6): 870-875.
13.	周曉, 芮永軍, 薛明宇, 等. 鼻咽窩穿支 V-Y 接力皮瓣修復拇指指背動脈皮瓣供區. 中國修復重建外科雜志, 2014, 28(7): 923-924.
14.	郭峭峰, 黃凱, 沈立鋒, 等. 穿支蒂螺旋槳皮瓣在下肢骨折術后切口愈合不良中的應用. 中華創傷雜志, 2017, 33(2): 118-122.
15.	孫廣峰, 吳必華, 吳祥奎, 等. 應用優化腓動脈低位穿支螺旋槳皮瓣修復足踝、足跟后外側創面. 中華整形外科雜志, 2017, 33(6): 441-444.
16.	呂荼, 李子華, 黃若強. 腓動脈穿支接力皮瓣修復手足部創面的療效. 中國矯形外科雜志, 2016, 24(20): 1859-1863.
17.	周飛亞, 池征璘, 張弦, 等. 以掌背動脈為蒂的接力皮瓣修復指背供區創面的臨床應用. 中華手外科雜志, 2018, 34(2): 90-92.

1. 梁尊鴻, 潘云川, 林師帥. 脛后動脈穿支皮瓣接力修復足踝部及皮瓣供區軟組織缺損. 中華顯微外科雜志, 2018, 41(5): 490-492.
2. 豐波, 張志, 呼和, 等. 小腿穿支皮瓣修復踝周皮膚軟組織缺損. 中華顯微外科雜志, 2014, 37(2): 139-142.
3. Ducic I, Attinger CE. Foot and ankle reconstruction: pedicled muscle flaps versus free flaps and the role of diabetes. Plast Reconstr Surg, 2011, 128(1): 173-180.
4. 侯春林, 曹誼林, 徐永清. 中國修復重建外科歷史回顧. 中國修復重建外科雜志, 2018, 32(7): 177-180.
5. 潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3): 130-135.
6. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
7. 侯春林, 顧玉東. 皮瓣外科學. 2 版. 上海: 上海科學技術出版社, 2013: 631-638.
8. Lee JH, Chung DW. Reverse lateral supramalleolar adipofascial flap and skin grafting for one-stage soft tissue reconstruction of foot and ankle joint. Microsurgery, 2010, 30(6): 423-429.
9. 金文虎, 常樹森, 魏在榮, 等. 接力逆行腓動脈穿支皮瓣修復足踝部及共瓣區皮膚軟組織缺損. 中華創傷雜志, 2018, 34(7): 624-629.
10. 宋達疆, 李贊, 周曉, 等. 接力腓腸外側動脈穿支螺旋槳皮瓣修復逆行腓腸神經皮瓣供區. 中國修復重建外科雜志, 2017, 31(11): 1363-1366.
11. 王耀軍, 任忠亮, 薛佳杰, 等. 腓動脈穿支接力皮瓣修復脛前中下段及供瓣區皮膚軟組織缺損. 中華整形外科雜志, 2018, 34(12): 1005-1009.
12. Chi Z, Lin D, Chen Y, et al. Routine closure of the donor site with a second dorsal metacarpal artery flap to avoid the use of a skin graft after harvest of a first dorsal metacarpal artery flap. J Plast Reconstr Aesthet Surg, 2018, 71(6): 870-875.
13. 周曉, 芮永軍, 薛明宇, 等. 鼻咽窩穿支 V-Y 接力皮瓣修復拇指指背動脈皮瓣供區. 中國修復重建外科雜志, 2014, 28(7): 923-924.
14. 郭峭峰, 黃凱, 沈立鋒, 等. 穿支蒂螺旋槳皮瓣在下肢骨折術后切口愈合不良中的應用. 中華創傷雜志, 2017, 33(2): 118-122.
15. 孫廣峰, 吳必華, 吳祥奎, 等. 應用優化腓動脈低位穿支螺旋槳皮瓣修復足踝、足跟后外側創面. 中華整形外科雜志, 2017, 33(6): 441-444.
16. 呂荼, 李子華, 黃若強. 腓動脈穿支接力皮瓣修復手足部創面的療效. 中國矯形外科雜志, 2016, 24(20): 1859-1863.
17. 周飛亞, 池征璘, 張弦, 等. 以掌背動脈為蒂的接力皮瓣修復指背供區創面的臨床應用. 中華手外科雜志, 2018, 34(2): 90-92.

Chinese Journal of Reparative and Reconstructive Surgery

Anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap for foot and ankle defect

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