OBJECTIVETo explore surgical method and clinical effects of descending branch of the anterior lateral malleolar artery based anterograde island flap for repairing foot and ankle wounds.

METHODSNine patients with skin defects of foot and ankle repaired by descending branch of the anterior lateral malleolar artery based anterograde island flap were studied from June 2015 to January 2017, including 6 males and 3 females aged from 32 to 63 years old. The wound were located on foot and ankle and associated with exposure of bone, tendon, blood vessels or nerves. The surface of wound located on foot in 6 patients, and 3 patients in ankle joint. The area of defect ranged from 1.5 cm×2.0 cm to 6.0 cm×13.0 cm, and the area of flap ranged from 2.0 cm×3.0 cm to 7.0 cm×15.0 cm. The donor site was skin grafted with split-thickness skin from abdomen. Appearance, texture, condition of donor site of island flaps after operation were observed, satisfied degree of clinical effects were evaluated by ZHANG Hao's evaluation, and AOFAS score were used to evaluate function.

RESULTSCirculations of flaps in 9 cases were stable without blockage, and healed well at 2 weeks after operation. All patients were followed up from 2 to 18 months with an average of(8.0±2.3) months. All flap were survived at stage I, pedicles looked smooth and tidy, no cat-ear formed, the texture of flap was soft with satisfied appearance, the color was near to surrounding skin. The surface of wound were tidy after skin graft of donor sites without scar hypertrophy. Nine patients got satisfied results according to ZHANG Hao's evaluation, and AOFAS score was excellent.

CONCLUSIONSDescending branch of the anterior lateral malleolar artery based anterograde island flap for repairing foot and ankle wounds, which has advantages of protect main vessel, thin flap, is a simple and effective method.