Distally Based Adipofascial Flaps for Dorsal Foot and Ankle Soft Tissue Defects

• Published in: The Journal of foot and ankle surgery Vol. 46; no. 6; pp. 464 - 469
• Main Author: Suliman, M. Taifour, MD, FRCS
• Format: Journal Article
• Language: English
• Published: Baltimore, MD Elsevier Inc 01.11.2007; Data Trace
• Subjects: Accidents, Traffic; adipofascial; Adipose Tissue - transplantation; Adult; ankle; Ankle Injuries - surgery; Biological and medical sciences; Child; Child, Preschool; distally based; dorsal foot; Fascia - transplantation; Female; flap; Follow-Up Studies; Foot Injuries - surgery; Graft Survival; Humans; Male; Medical sciences; Orthopedic surgery; Orthopedics; Reconstructive Surgical Procedures - methods; Skin Transplantation - methods; soft tissue; Soft Tissue Injuries - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps - blood supply; Surgical Flaps - pathology; Treatment Outcome; adipofascial; distally based; flap; soft tissue; ankle; dorsal foot; Ankle; Ankle joint; Soft tissue defect; Treatment; Soft tissue; Flap (surgery); Foot
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2007.08.002

Soft tissue defects of the dorsal foot and ankle are difficult to reconstruct because the contour of the foot must be maintained for shoe fitting. The adipofascial flap, covered with a skin graft, is a suitable method of reconstruction that fulfills this important requirement. Twelve patients with soft tissue defects of the dorsal foot and at the ankle were treated in our unit with this method. Ten (83%) were children, 2 (17%) were adults. All defects were due to road traffic accidents. Three (25%) patients were women; 9 (75%) were men. The right foot was affected in 10 (83.4%) patients, with 2 (16.6%) patients having the left foot involved. The flaps used were the peroneal artery perforator flap (distally based lateral adipofascial flap) in 9 (75%) patients, the superficial sural artery flap in 2 patients (17%), and the posterior tibial artery perforator flap (distally based medial adipofascial flap) in 1 patient (8%). All flaps were successful, providing adequate contour of the foot for wearing ordinary shoes. There were 2 partial skin graft necroses, and, in 1 patient, the tips of the donor site skin flaps were necrosed. In conclusion, the distally based adipofascial flap, covered with skin graft, is a suitable method for reconstruction of soft tissue loss of the dorsal foot and ankle and provides optimum functional and aesthetic outcome with minimum donor site morbidity.