Volume 134, Number 4S-1 (Supplement) • Supplement to Plastic and Reconstructive Surgery® www.PRSJournal.com 115 Sunday, October 12Ruan, et al., incorporated the main trunk of the peroneal artery to obtain a longer pedicle reaching the lateral knee area. 2 The proximally rotated peroneal perforator flap can reach the proximal area of the lower leg.The purpose of this paper is to present a technical modifi cation for the antegrade peroneal perforator fl ap for increasing pedicle length and arc of rotation. This involves creating a tunnel through the interosseous membrane through which the fl ap can be passed. An anatomical study in 8 fresh cadaveric specimens was done to measure the gain in pedicle length when the fl ap is tunneled compared to the direct transfer around the fi bula. METHODS:A 15 x 7cm peroneal fl ap based on the distal perforator was raised from the lateral part of the leg. The peroneal artery was ligated distal to the origin of this perforator and dissected proximally up to its origin at the bifurcation of the tibio-peroneal trunk. The fl ap was transferred around the fi bular bone to the area of the anterior knee. The proximal position on the anterior knee to which the fl ap easily reached was marked. Then the same fl ap was brought back, tunneled through the interosseous membrane and transfer to the anterior knee. The new position was marked and compared with the previous one. RESULTS:There was a difference of 8 cm in the reach of the fl ap so that it easily reaches all aspects of the knee as well as the distal upper leg.5 Clinical cases have been successfully performed. A clinical example of this fl ap will be presented and technical aspects of fl ap transfer highlighted. CONCLUSION:A simple modification of the peroneal perforator fl ap is presented. This signifi cantly increases the reach of the fl ap and improves its versatility for reconstructing defects of the lower extremity. REFERENCES:1. Donski PK, Fogdestam I. Distally based fasciocutaneous fl ap from the sural region. A preliminary report. Scand J Plast Reconstr Surg. 1983;17:191-6. 2. Ruan HJ, Cai PH, Schleich AR, Fan CY, Chai YM. The extended peroneal artery perforator fl ap for lower extremity reconstruction.
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