Distally-based superficial sural neurocutaneous flap for reconstruction of the ankle and foot in children

Abstract

There are various options for covering soft tissue defects in the lower extremities, but the distal third of the leg continues to be a difficult area. The distally-based sural neurocutaneous flap which is based on the sural nerve and the superficial sural artery has been an important option since it was first proposed. 16 children, with an average age of 9 years had different local lesions on the distal third of the leg or foot which compromised the Achilles tendon, extensor tendons in the foot and toes or the osteoarticular system, were treated using the distally-based sural flap. One patient had an amputation at midfoot caused by a garden strimmer, seven had lesions caused by motorcycle accidents and eight were caused by car accidents. The minimum follow up was 8 months. In all cases, the lesions were successfully covered. Only one showed necrosis of the flap, but the adipofascial tissue was well irrigated and was resurfaced by a free skin graft. The distally-based sural neurocutaneous flap is a good alternative for soft tissue defects in the distal area of the leg, a region where it is historically difficult to cover soft tissue defects.