OBJECTIVETo evaluate the effect of lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle.

METHODSFrom May 2009 to October 2013,12 patients with soft tissue defects combined with tendon and bone exposure in the foot and ankle were treated by lateral supramalleolar artery descending branch antidromic flap for the repair of soft tissue defects in the foot and ankle, including 9 males and 3 females with an average age of 37.5 years old ranging from 19 to 58 years. Ten cases had the soft tissue defects in the dorsum of foot and 2 in the ankle. The defect area of soft tissue was from 11 cm x 9 cm to 8 cm x 5 cm.

RESULTSTwelve patients were follow-up for 3 to 12 months (averaged 7.3 months). The flaps of 9 cases were survived,the flaps edges of the other 3 cases were necrosis,and healed after dressing change. The flaps were slightly swelling without ulcer occurrence.

CONCLUSIONLateral supramalleolar artery descending branch antidromic flap can repairing the damage by one-stage operation with advantage of dissection easy,rich blood supply without sacrifice of major artery.

Adult ; Ankle ; blood supply ; surgery ; Arteries ; surgery ; Female ; Foot ; blood supply ; surgery ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Young Adult

A 68-year-old female patient was treated for unhealed ulcer in the fourth toe of the left foot. Clinical examinations identified severe stenosis of the proximal segment and occlusion of the distal segment of the left anterior tibial artery, and occlusion of the left posterior tibial artery and the peroneal artery. The proximal stenotic segment of the left anterior tibial artery was dilated, but the distal occlusive part failed to be re-canalized. Left anterior tibial artery to dorsal pedal artery bypass was performed on the patient with an epoxide-crosslinked, special radicals antigen-sealed, porcine-derived biological graft; debridement of the left 4th digiti pedis was also performed. Postoperation course was uneventful. The pulse of the left dorsal pedal artery was strong. The ankle brachial index (ABI) increased from 0.60 to 1.09. Warfarin and two antiplatelet drugs were given after the operation. Six months after operation, computed tomographic angiogram (CTA) identified the patent graft.
Aged ; Blood Vessel Prosthesis ; Diabetic Foot ; surgery ; Female ; Humans ; Ischemia ; surgery ; Leg ; blood supply

OBJECTIVETo explore the blood supply of the reverse arterial arch at the superior border of the hallucal abductor island flap and provide an anatomical basis for repairing fore foot skin defect using this flap.

METHODSThe constitution, course, distribution, and external diameter of the arterial arch at the superior border of the hallucal abductor, and the concomitant veins and nerves were observed on 12 sides of formaldehyde-fixed and 12 fresh adult foot specimens perfused with red latex. The surgical approach using the arterial arch at the superior border of the hallucal abductor for repairing fore foot skin defect were designed.

RESULTSThe arterial arch at the superior border of the hallucal abductor, constituted by the branch of the medial tarsal artery or the branch of the anterior medial malleolus artery anastomosed with the superficial branch of the medial basal hallucal artery or the branch of the superficial branch of the medial plantar artery or the all the four branches, functioned as the axis of the medial tarsal, the medialis pedis and the medial plantar. The external diameters of the anterior medial malleolus artery, the medial tarsal artery, the branch of the superficial branch of the medial plantar artery, and the distal arterial arch at the superior border of the hallucal abductor were 1.02∓0.03 mm, 0.73∓0.04 mm, 0.56∓0.02 mm, and 0.53∓0.14 mm, respectively. Most of the arteries (91.67%) had one concomitant vein with the external diameters of 1.01∓0.03 mm, 0.81∓0.04 mm, 0.57∓0.01 mm, and 0.61∓0.02, respectively, and only a small fraction of them (8.33%) had two concomitant veins.

CONCLUSIONSThe fore foot skin defect can be repaired using this flap supplied by the branch of the anterior medial malleolus artery and the medial tarsal artery, the superficial branch of the medial plantar artery, or all the three. The pivot point formed by the neck of the first metatarsal or metatarsophalangeal joint allows for long vessel pedicles and larger flap areas to increase the flexibility of surgery.

Foot Injuries ; surgery ; Humans ; Muscle, Skeletal ; anatomy & histology ; blood supply ; Skin ; injuries ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply

OBJECTIVETo investigate the therapeutic effect of island flap pedicled with lateral tarsal artery for forefoot skin defect.

METHODSFrom March 2007 to January 2009, 12 cases with forefoot skin defects were treated by reversed island flap pedicled with lateral tarsal artery.

RESULTSAll the flaps survived completely with a followed-up period of 8-22 months, 13 months in average. The flaps and skin grafts had soft texture and a similar color as the surrounding skin. The flaps had a suitable thickness with deep pain sensation. Shallow touch and pain sensation recovered in the skin graft and within 1-2 cm of the flap edge, which was graded as S1-S2. There was no problem in shoes-wearing and walking. No flap ulcer happened.

CONCLUSIONIsland flap pedicled with lateral tarsal artery is suitable for forefoot skin defect, leaving less morbidity to donor site.

Adult ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply

OBJECTIVETo investigate the clinical effect of reversed plantar metatarsal artery island flap in repairing the plantar soft tissue defects at the first and second toes.

METHODS12 cases with plantar soft tissue defects at the first and second toes were repaired by reversed plantar metatarsal artery island flap which size ranged from 2 cm x 3 cm to 4 cm x 6 cm, including 5 cases at emergency, 5 cases with the donor site defects at great toes after free lateral pulp flap transfer, and 2 cases with the donor site defects at second toes after free medial pulp flap transfer.

RESULTSAll the reversed plantar metatarsal artery island flaps at the first and second toes survived uneventfully with desirable appearance and sensation over a 3-35 month follow-up. No complication happened at the donor sites.

CONCLUSIONSIt is an reliable method to adopt the reversed plantar metatarsal artery island flap for the plantar soft tissue defects at the first and second toes, with the advantages of stable blood vessels, high survival rate, good skin texture and few complications.

Arteries ; Foot ; Humans ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; transplantation ; Toes ; Transplant Donor Site ; blood supply

No abstract available.
Endovascular Procedures/*methods ; Female ; Foot/*blood supply ; Humans ; Ischemia/*surgery ; Male ; Wound Healing/*physiology

OBJECTIVETo study a new method of the vascularized plantaris tendon transferring.

METHODSThe vascularized plantaris tendon was elevated with the pedicle of the fascial perforating vessel or a small segment of the posterior tibial artery, which was transplanted to the wrist to repair the tendon defects of the flexor pollicis longus or the flexor digitorum muscle resulted from electric injury. According to the defects, the plantaris tendon can be used together with the skin, fascia, or both as a composite flap. 7 cases received the operation with complete survival of the flap.

RESULTSPostoperative follow-up showed satisfactory results in the 7 cases. Through physical exercises, the patients obtained increased joint motion and better function of the hand.

CONCLUSIONThe vascularized plantaris tendon has many advantages, including easy to harvest, easy to plerosis the donor site, little affect to a main vessel, able to repair the complex defects. This method has great potential for applications.

Electric Injuries ; surgery ; Fascia ; Foot ; Hand Injuries ; surgery ; Humans ; Surgical Flaps ; blood supply ; transplantation ; Tendons ; blood supply ; transplantation ; Tibial Arteries ; Transplants ; Wrist Injuries ; etiology ; surgery

OBJECTIVETo investigate the operative method and effect of the reversed sural neurocutaneous flap in repairing soft tissue defects of the anterior foot and the ankle.

METHODSFrom March 1999 to November 2004, 19 cases (17 male, 2 female) of soft tissue defects of the anterior foot and the ankle were repaired with the reversed sural neurocutaneous flaps. The flap sizes range from 18 cm x 9 cm to 30 cm x 18 cm.

RESULTSAll flaps survived well, while 1 flap had distal partial necrosis and healed after dressing change. The follow-up from 6 months to 2 years showed that all flaps were satisfactory.

CONCLUSIONSural neurocutaneous flap is easy to get and to survive. It is an effective method to repair the soft tissue defects of the anterior foot and the ankle.

Adolescent ; Adult ; Ankle ; blood supply ; surgery ; Female ; Foot ; blood supply ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps

OBJECTIVETo investigate the therapeutic effect of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot.

METHODSFrom Aug. 2008 to Aug. 2010, 9 cases with skin defects at the dorsal side of feet were treated by V-Y flaps pedicled with superior malleolus cutaneous branch. The flap size ranged from 6.0 cm x 5.5 cm to 12.0 cm x 6.5 cm. The defects at the donor sites were closed directly.

RESULTSAll flaps survived completely. 9 cases were followed up for 6-12 months after operation. The flaps had good texture and color match. The 2-point discrimination distance at the flap was 10-14 mm. The function of ankle was normal.

CONCLUSIONSThe V-Y flap pedicled with superior malleolus cutaneous branch is ideal for the treatment of small skin defect at the dorsal side of foot.

Adolescent ; Adult ; Aged ; Ankle ; blood supply ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Young Adult

OBJECTIVETo investigate the clinical application of reversed sural neurofasciocutaneous flaps in children.

METHODSFrom January 2002 to January 2007, 16 children patients with deep defect of foot and ankle were treated with reversed sural neurofasciocutaneous flaps. The size of the flaps ranged from 6.5 cm x 5.0 cm to 17 cm x 10 cm. The upper margin of the flaps reached the upper one-third of the leg in 10 cases, with 2 cases reaching the popliteal fossa and 1 case reaching 1.5 cm above the transverse line of popliteal fossa.

RESULTSThe flaps survived completely in 14 cases. There were partial necrosis at the distal end of flap in one case and superficial necrosis at the distal end of the flap in one case. The wounds were healed spontaneously after secondary suture and dressing change. The patients were followed up for 2 - 46 months with good aesthetic results.

CONCLUSIONSThe reverse sural neurofasciocutaneous flaps in children has a reliable survival area, which can reach the upper on -third of the leg until the transverse line of popliteal fossa. It is an ideal reconstructive method for deep defect of foot and ankle.

Ankle Injuries ; surgery ; Child ; Child, Preschool ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Skin Transplantation ; Sural Nerve ; blood supply ; transplantation ; Surgical Flaps ; blood supply