Reverse Sural Flap for Lower Limb Reconstruction

CLIVATTI, GUSTAVO MOREIRA; NASCIMENTO, BRUNO BAPTISTA DO; RIBEIRO, RENAN DIEGO AMÉRICO; Milcheski, Dimas André; AYRES, ARALDO MONTEIRO; Gemperli, Rolf

doi:10.1590/1413-785220223004e248774

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Late management of open fractures of the ankle and foot puts patients at risk of osteoarthritis and amputations. The use of the distal pedicle sural flap has been recommended by various authors for its reliability and low morbidity [12,14,19] . It can be used in the homolateral or heterolateral hamstring.…”

Section: Discussionmentioning

confidence: 99%

Results of ankle and foot skin loss coverage with sural flap at regional hospital of Sokode

Dellanh,

Kouevi-Koko,

Towoezim

et al. 2024

Nat. J. Clin. Orthop.

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Introduction:The objective was to report on the clinical and evolutionary aspects after coverage of posttraumatic skin loss of the foot and ankle with a sural flap at the Sokodé Regional Hospital. Patients and Methods: This was a retrospective study of 17 patients aged > 15 years managed from July 1, 2019 to July 30, 2023, a period of 48 months in the Orthopaedics Department. These were open malleolar fracture in n = 09 cases and tibial pilon fracture n = 05 cases and open forefoot fracture in n = 03 cases. The sural flap was performed in all cases, as a cross leg flap in 02 cases. The parameters reported were operative time, clinical appearance at 03 weeks, at 03 months, flap weaning time, and appearance of the donor zone at 03 months. Results and Discussion: The average operating time after the first surgical trimming was 02 weeks. At 03 weeks post-operatively, good flap take-up was noted in n = 13 cases, and skin damage to the flap edges with partial necrosis in n = 04 cases. At 03 months, good flap integration was noted in all cases (n=17), with healing of the donor area. Flap weaning was effective in only n = 07 cases Conclusion: The sural flap provides reliable coverage of ankle defects, avoiding osteoarthritis and amputation. This easily reproducible procedure should be mastered by every orthopedic surgeon.

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Section: Discussionmentioning

confidence: 99%

Results of ankle and foot skin loss coverage with sural flap at regional hospital of Sokode

Dellanh,

Kouevi-Koko,

Towoezim

et al. 2024

Nat. J. Clin. Orthop.

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Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap

Lee,

Yang

et al. 2023

Medicina

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Introduction: Distal tibial fractures make up approximately 3% to 10% of all tibial fractures or about 1% of lower extremity fractures. MIPO is an appropriate procedure and method to achieve stable metal plate fixation and osseointegration by minimizing soft tissue damage and vascular integrity at the fracture site. MIPO to the medial tibia during distal tibial fractures induces skin irritation due to the thickness of the metal plate, which causes discomfort and pain on the medial side of the distal leg, and if severe, complications such as infection and skin defect may occur. The reverse sural flap is a well-researched approach for covering defects in the lower third of the leg, ankle, and foot. Materials and Methods: Among 151 patients with distal tibia fractures who underwent minimally invasive metal plate fixation, soft tissue was injured due to postoperative complications. We treated 13 cases with necrosis and exposed metal plates by retrograde nasogastric artery flap surgery. For these patients, we collected obligatory patient records, radiological data, and wound photographs of the treatment results and complications of reconstructive surgery. Results: In all the cases, flap survival was confirmed at the final outpatient follow-up. The exposed area of the metal plate was well coated, and there was no plate failure due to complete necrosis. Three out of four women complained of aesthetic dissatisfaction because the volume of the tunnel through which the skin mirror passed and the skin plate itself were thick. In two cases, defatting was performed to reduce the thickness of the plate while removing the metal plate. Conclusions: Metal plate exposure after distal tibial fractures have been treated with minimally invasive metal plate fusion and can be successfully treated with retrograde nasogastric artery flaps, and several surgical techniques are used during flap surgery.

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Reverse Sural Flap for Lower Limb Reconstruction

Cited by 2 publications

References 16 publications

Results of ankle and foot skin loss coverage with sural flap at regional hospital of Sokode

Results of ankle and foot skin loss coverage with sural flap at regional hospital of Sokode

Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap

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