Distally based perforator-plus sural fasciocutaneous flap for reconstruction of complex soft tissue defects caused by motorcycle spoke injury in children

M spoke injury is common in children, and it may result in complex soft tissue defects over the Achilles tendon and heel. Many flaps, such as pedicled flaps, perforator flaps, and free flaps, have been described to resurface the defects. Each flap has respective advantages, disadvantages, and indications. Mehrotra et al. first introduced the concept of perforator-plus flap. Harvesting a distally based sural flap, we began with exploring the peroneal arterial perforators near the pivot point; if necessary, the flap was redesigned with pivot point adjusted to the site of the identified perforator. The surgical tips can ensure the flap becoming a distally based perforator-plus sural fasciocutaneous flap. The purpose of this article is to describe our experience in reconstruction of the soft tissue defects in children using distally based perforator-plus sural fasciocutaneous flap.

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