Clinical application of island flap with a pedicle of the descending branch of perforating branch from lateral anterior malleolus of peroneal artery in repairing midfoot and forefoot soft tissue defects

Objective To explore clinical application of the island flap pedicled of the descending branch of perforating branch from lateral anterior malleolus of peroneal artery in repairing the soft tissue defects in midfoot and forefoot. Methods From January, 2010 to December, 2016, based on the anastomosis between the descending branch from a terminal branch of peroneal artery on the anterior aspect of the lateral malleolus and other branches located around the ankle joint and sinus tarsi, island flap with a pedicle could be harvested more distally and to be used in covering the soft tissue defects in midfoot and forefoot of 5 patients. Sizes of the flap were from 15 cm×12 cm to 8 cm×6 cm. All patients were followed-up in outpatient clinic or through WeChat. The appearance of the flaps and ankle function were recorded simultaneously. Results All flaps were survived without any secondary surgeries. During the follow-up of 6-15 months, the texture of flaps was good with satisfactory estheticity. Range of motion at the injured ankle was 15° in dorsi flexion and 25° in plantar flexion. Conclusion The flap with a pedicle of the descending branch of perforating branch from lateral anterior malleolus of peroneal artery is good enough to be used in the reconstruction of soft tissue defects in midfoot and forefoot. Key words: Peroneal artery; Terminal perforating branch; Island flap; Microsurgical technique