Objective To report retrograde transposition of composite tissue flap pedicled with peroneal artery in the treatment of bone and soft tissue defects following calcaneal osteomyelitis.Methods During the period from January 2008 through January 2015,47 patients with bone and soft tissue defects following calcaneal osteomyelitis were treated by retrograde transposition of composite tissue flap pedicled with peroneal artery.They were 43 men and 4 women,aged from 24 to 67 years(average,43.6 years).After radical focus debridement,the areas of skin defect ranged from 2 cm × 2 cm to 5 cm× 5 cm and the bone defects ranged from 1.5 cm × 1.0 cm × 2.0 cm to 3.0 cm × 3.0 cm × 4.5 cm.Results All the 47 patients were followed up for 6 to 72 months (average,25.2 months).Relapse of osteomyelitis occurred in 2 cases but secondary bone graft was needed in none.All the patients recovered their walking function.The texture and color of the composite tissue flaps were similar to those of normal skin,without obvious swelling.The flaps appeared good and imposed no obstacle to wearing shoes.The ankles and hind feet of the patients scored from 58 to 91 points (average,76.6 points) according to the American Orthopaedic Foot and Ankle Society (AOFAS) evaluation system,giving 7 excellent,32 good and 8 fair cases.Hallux flexion contracture without skin ulcer was observed in 10 cases 6 months after surgery,necessitating no surgical intervention.Conclusion Retrograde transposition of composite tissue flap pedicled with peroneal artery can effectively treat bone and soft tissue defects following calcaneal osteomyelitis,leading to a low recurrence rate and good foot appearance.