Use of Lateral Calcaneal Flap for Coverage of Hindfoot Defects: An Anatomical Appraisal.

Panagiotis Zygouris,Evangelos Kotsiomitis,Adamantios Michalinos,Antonios Mazarakis,Theodore Troupis,Ioannis Dimovelis,Vassilis Protogerou

doi:10.1155/2015/212757

Panagiotis Zygouris, Evangelos Kotsiomitis + Show 5 more

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https://doi.org/10.1155/2015/212757

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Abstract

Lateral calcaneal flap is an established surgical option for coverage of lateral calcaneum and posterior heel defects. Lateral calcaneal flap vascularization and innervations are based on lateral calcaneal artery neurovascular bundle, that is, lateral calcaneal artery, small saphenous vein, and sural nerve. Anatomical research has allowed exploration of its many advantages but can also lead to its various modifications, permitting a wide variety of clinical applications. In this paper the authors report an anatomical and clinical study on lateral calcaneal artery course and lateral calcaneal flap clinical applications. Anatomic part of our study focused on lateral calcaneal artery course and optimization of surgical technique for flap harvesting. Data were used for design of lateral calcaneal flap in 5 patients. Our results were satisfactory in terms of coverage adequacy, perioperative morbidity, and functional and aesthetical outcome.

Highlights

Posterior heel and lateral calcaneum defects are often difficult in their restoration because of their osseous or tendinous bed, poor area vascularization, continuous movement, and high functional demands
Lateral calcaneal flap is based on lateral calcaneal artery (LCA) neurovascular bundle consisting of LCA, small saphenous vein, and sural nerve
Investigation of LCA anatomy has led to various modifications of lateral calcaneal flap, including its island form [6], its adipofascial form [7], its reverse form [8], and its V-Y advancement form [9]

Summary

Introduction

Posterior heel and lateral calcaneum defects are often difficult in their restoration because of their osseous or tendinous bed, poor area vascularization, continuous movement, and high functional demands. Lateral calcaneal flap is an important surgical option for coverage of hindfoot defects. Its advantages include adequate coverage of posterior heel and lateral calcaneum [3], high success rate, low perioperative morbidity [4], and good functional results [5]. Investigation of LCA anatomy has led to various modifications of lateral calcaneal flap, including its island form [6], its adipofascial form [7], its reverse form [8], and its V-Y advancement form [9]

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