Abstract:

Objective　To investigate the clinical effects of repairing foot and ankle wounds by the antegrade or retrograde posterior tibial artery perforator flap.    Methods    13 cases with skin defects of foot and ankle were repaired using the antegrade or retrograde the posterior tibial artery perforator flap. 5 wounds were located in the dorsal aspect of the foot, 3 wounds located in the heel , and  5 wounds e located in the medial aspect. 4 defects with exposed bone or tendon underwent emergency operation of the posterior tibial artery perforator flap, 5 cases with no deep tissues exposure underwent emergent vacuum sealing drainage and a second stage flap surgery, and the other 4 cases with skin necrosis received a perforator flap coverage in second stage. The defects ranged from 1.5 cm×2.0 cm to 7.0 cm×14.0 cm. Antegrade or retrograde perforator flaps of posterior tibial artery with a size ranging from 2.5 cm×3.5 cm to 8.0 cm×15.0 cm were used to repair foot and ankle wounds.    Results    All flaps and skin grafts survived. The patients were followed up for 6 months to 18 months, with an average of 12months.The flap texture was similar to the normal skin with no significant bulky appearance. Scar was small at the direct suture skin donor sites and skin graft donor sites had no obvious scar. Good ankle flexion and extension, normal gait after operation were achieved.    Conclusion  the antegrade or retrograde posterior tibial artery perforator flap is a good method for repairing the foot and ankle wounds.

Key words:  Foot and ankle, Sugical flaps, Soft tissue defect, Skin transplantation