The lateral supramalleolar flap as solution for lower leg, ankle and foot defects: a surgical case series

Abstract

Introduction. One of the most challenging regions of the body to cover is the lower part of the leg, the ankle, and the foot, especially with the exposure of bones or tendons. Many options for covering soft tissue defects in this area have been proposed. This article describes the lateral supramalleolar flap, which is used for the reconstruction of defects of the lower leg, ankle, heel, and foot. This flap is a surgical technique to salvage the lower extremity due to its large skin paddle and a wide rotation arc. In this case series, patients with lower leg and ankle defects requiring flaps had the lateral supramalleolar flaps performed. This article discusses the overview, technique, and outcomes.Methods. These flaps were performed under spinal anesthesia and tourniquet control. The upper limit of the flap was about 8 cm from the popliteal crease, and the lower border was 5 cm from the axis of the ankle joint. The lateral extent of the flap was up to the fibula, contrary to mid-calf. The flap was harvested in the sub-facial plane, and the donor site was grafted.Results. The Flap was generally easy to raise and secure in place at the donor site. Partial necrosis of the flap was reported in one case. The overall donor site morbidity was minimal.Conclusion. The lateral supramalleolar flap is a reliable and useful flap for coverage of the lower third of the leg, ankle, and dorsal foot defects. It is a viable option available to the reconstructive surgeon, especially with the exposure of bones or tendons.Â