Repair of soft tissue defect of foot and ankle with the supercharged peroneal artery perforator propeller flap

Objective To explore the clinical technical points of the treatment of soft tissue defect of the foot and ankle with the supercharged peroneal artery perforator propeller flap, and to provide theoretical support by anatomical observation. Methods From January, 2010 to February, 2018, a total of 10 patients with soft tissue defect of foot and ankle were treated with supercharged peroneal artery perforator propeller flap. Cause of injury: trauma in 7 cases, wound ulcer in 1 case, and poor healing of the calcaneus incision in 2 cases. Defect site: 5 cases of heel, 2 cases of medial and lateral malleolus, and 3 cases of dorsum and sole. The size of flap ranged from 6.0 cm×3.0 cm to 16.0 cm×5.0 cm. All patients were followed-up at 1, 3, 6 months after operation, and the function recovery was judged by AOFAS Ankle Hindfood Scale at 3 months post-opertively. From November, 2016 to May, 2017, the anatomical basis and operative points of the supercharged peroneal artery perforator flap were summarized. Results All the 10 cases of supercharged peroneal artery perforator propeller flap survived. Two of them had local epidermal necrosis at the proximal end of the flap. After 1 to 2 weeks of dressing, they finally healed. The other 8 cases healed well. Anatomical studies showed that different planes of the supercharged peroneal artery perforator propeller flap can only reduce the compression of the double pedicles and reduce the distal necrosis rate of the flap by rotating in different rotation directions. Conclusion The supercharged peroneal artery perforator propeller flap can enhance the blood supply and venous return in the "big paddle" artery of the flap, preventing distal necrosis. Key words: Peroneal artery perforator flap; Propeller flap; Supercharged; Foot and ankle