The peroneal artery perforator flap for the reconstruction of serious heel spoke injuries in children

Abstract

Objective To explore the clinical effect of peroneal artery perforator flap for the treatment of serious heel spoke injuries in children. Methods From July, 2014 to September, 2017, 13 children with severe heel and ankle injuries were treated by peroneal artery perforator flap. There were 9 males and 4 females, with an average age of 6.5 years (ranged from 3 to 11 years). The size of flaps ranged from 10.0 cm×3.0 cm to 14.5 cm×5.0 cm. The donor sites were sutured directly or covered with skin grafting. Regular follow-up was performed to observe the survival status of the flap and the functional recovery of the ankle joint. Results Twelve flaps survived completely. One flap had partial marginal necrosis in the distal portion, which was healed after dressing. Partial inadequate venous return happened in 1 case, which also recovered by the removal of part of the suture. All cases were followed-up for 3 months to 20 months. The appearance, texture, and color of the flaps were similar to the surrounding skin. No ulcer occurred. All case acquired normal gait. Conclusion The peroneal artery perforator flap is a good option for reconstruction of serious heel spoke injuries in children. The flap has consistent blood supply while leaving minimal morbidity at donor site. Key words: Peroneal artery; Perforator flap; Spoke injury; Children; Heel