Repair of soft tissue defect in the heels of children with the perforator flaps of the posterior tibial artery with nerve anastomosis

Abstract

Objective To summarize the clinical application of using pedicle perforator flaps of the posterior tibial artery with nerve anastomosis for the repair of soft tissue defect of the heel in children.Methods Nine the pedicle perforators flaps were used to repair soft tissue defect in the weightbearing areas of the heel in children.They ranged in age from 4 to 12 years (mean 7.5 y).The sizes of the flaps ranged from 12 cm× 6 cm to 6 cm × 4.5 cm.All the donor sites were closed by meshed full thickness skin grafts.The saphenous nerve of the flap was anastomosed to the sural nerve at the heel area.Results All flaps had survived completely and satisfactory clinical results were obtained.The follow-up period ranged from 1.5 to 4 years (mean 2.5 y).The flaps recovered sensation,with good two-point discriminations (from 30 mm to 33 mm).Conclusions Perforators flaps of the posterior tibial artery were excellent for repair of soft tissue defect in the weight-bearing areas of the heel in children because of a constant vascular anatomy,high tissue vascularity,and a simple surgical procedure to perform. Key words: Microsurgery; Flaps; Heel; Soft tissue injuries