Clinical Evaluation of Peroneous Brevis Muscle Flap as a Reconstructive Tool for Defects Around the Ankle

Abstract

Background: Soft tissue defects of the distal lower extremityare notoriously difficult wounds to treat. This is dueto the paucity of soft tissue in this area and the thin integumentas well as the relatively superficial tendons. Those defectsoften require local rotation flaps, the reverse flow flap or freetissue transfer. The success of local tissue rotation flaps canbe improved with supercharging techniques; however, just aswith free tissue transfers, these techniques require specialsurgical skills. One excellent alternative within the reconstructivespectrum of the lower leg is the distally based peroneusbrevis muscle flap. This muscle flap is a viable option inproperly selected patients for coverage of wounds about theankle.Patients and Methods: In this study, we used the distallybased peroneous brevis muscle flap to reconstruct 20 casesof defects around the ankle. Cases presented to Plastic SurgeryDepartment, Minia University Hospital in period betweenJanuary to October 2017. Surgical procedure was performedunder spinal anaesthesia in all cases. We followed cases for6 months postoperatively.Results: The mean age was 35 years old, 16 patientswere males and 4 were female. 55% of patients had completeflap viability, 15% of cases had partial graft loss and 20%with partial flap necrosis and 10% of cases had completeflap loss.Conclusion: We can suggest that the peroneus brevismuscle flap is an additional valuable option for reconstructionof defects around the ankle because of its adjacent location,reliability, and the relative simplicity of technique. The surgicaltechnique is relatively easy, safe, and suitable for reconstructionof soft-tissue defects in a single stage.