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.	梁尊鸿, 潘云川, 林师帅. 胫后动脉穿支皮瓣接力修复足踝部及皮瓣供区软组织缺损. 中华显微外科杂志, 2018, 41(5): 490-492.
2.	丰波, 张志, 呼和, 等. 小腿穿支皮瓣修复踝周皮肤软组织缺损. 中华显微外科杂志, 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, 曹谊林, 徐永清. 中国修复重建外科历史回顾. 中国修复重建外科杂志, 2018, 32(7): 177-180.
5.	潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 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, 顾玉东. 皮瓣外科学. 2 版. 上海: 上海科学技术出版社, 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, 常树森, 魏在荣, 等. 接力逆行腓动脉穿支皮瓣修复足踝部及共瓣区皮肤软组织缺损. 中华创伤杂志, 2018, 34(7): 624-629.
10.	宋达疆, 李赞, 周晓, 等. 接力腓肠外侧动脉穿支螺旋桨皮瓣修复逆行腓肠神经皮瓣供区. 中国修复重建外科杂志, 2017, 31(11): 1363-1366.
11.	王耀军, 任忠亮, 薛佳杰, 等. 腓动脉穿支接力皮瓣修复胫前中下段及供瓣区皮肤软组织缺损. 中华整形外科杂志, 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.	周晓, 芮永军, 薛明宇, 等. 鼻咽窝穿支 V-Y 接力皮瓣修复拇指指背动脉皮瓣供区. 中国修复重建外科杂志, 2014, 28(7): 923-924.
14.	郭峭峰, 黄凯, 沈立锋, 等. 穿支蒂螺旋桨皮瓣在下肢骨折术后切口愈合不良中的应用. 中华创伤杂志, 2017, 33(2): 118-122.
15.	孙广峰, 吴必华, 吴祥奎, 等. 应用优化腓动脉低位穿支螺旋桨皮瓣修复足踝、足跟后外侧创面. 中华整形外科杂志, 2017, 33(6): 441-444.
16.	吕荼, 李子华, 黄若强. 腓动脉穿支接力皮瓣修复手足部创面的疗效. 中国矫形外科杂志, 2016, 24(20): 1859-1863.
17.	周飞亚, 池征璘, 张弦, 等. 以掌背动脉为蒂的接力皮瓣修复指背供区创面的临床应用. 中华手外科杂志, 2018, 34(2): 90-92.

1. 梁尊鸿, 潘云川, 林师帅. 胫后动脉穿支皮瓣接力修复足踝部及皮瓣供区软组织缺损. 中华显微外科杂志, 2018, 41(5): 490-492.
2. 丰波, 张志, 呼和, 等. 小腿穿支皮瓣修复踝周皮肤软组织缺损. 中华显微外科杂志, 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, 曹谊林, 徐永清. 中国修复重建外科历史回顾. 中国修复重建外科杂志, 2018, 32(7): 177-180.
5. 潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 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, 顾玉东. 皮瓣外科学. 2 版. 上海: 上海科学技术出版社, 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, 常树森, 魏在荣, 等. 接力逆行腓动脉穿支皮瓣修复足踝部及共瓣区皮肤软组织缺损. 中华创伤杂志, 2018, 34(7): 624-629.
10. 宋达疆, 李赞, 周晓, 等. 接力腓肠外侧动脉穿支螺旋桨皮瓣修复逆行腓肠神经皮瓣供区. 中国修复重建外科杂志, 2017, 31(11): 1363-1366.
11. 王耀军, 任忠亮, 薛佳杰, 等. 腓动脉穿支接力皮瓣修复胫前中下段及供瓣区皮肤软组织缺损. 中华整形外科杂志, 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. 周晓, 芮永军, 薛明宇, 等. 鼻咽窝穿支 V-Y 接力皮瓣修复拇指指背动脉皮瓣供区. 中国修复重建外科杂志, 2014, 28(7): 923-924.
14. 郭峭峰, 黄凯, 沈立锋, 等. 穿支蒂螺旋桨皮瓣在下肢骨折术后切口愈合不良中的应用. 中华创伤杂志, 2017, 33(2): 118-122.
15. 孙广峰, 吴必华, 吴祥奎, 等. 应用优化腓动脉低位穿支螺旋桨皮瓣修复足踝、足跟后外侧创面. 中华整形外科杂志, 2017, 33(6): 441-444.
16. 吕荼, 李子华, 黄若强. 腓动脉穿支接力皮瓣修复手足部创面的疗效. 中国矫形外科杂志, 2016, 24(20): 1859-1863.
17. 周飞亚, 池征璘, 张弦, 等. 以掌背动脉为蒂的接力皮瓣修复指背供区创面的临床应用. 中华手外科杂志, 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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