Reconstructive SurgeryThe Distally Based Peroneus Brevis Flap The 5-Step TechniqueTroisi, Luigi MD, FEBOPRAS*†; Wright, Thomas FRCS (Plast)*; Khan, Umraz FRCS (Plast)*; Emam, Ahmed T. FEBOPRAS*; Chapman, Thomas W.L. FRCS (Plast)*Author Information From the *Plastic Surgery Department, Southmead Hospital, North Bristol NHS Trust, Westbury-on-Trym, Bristol, United Kingdom; and †Department of Plastic and Reconstructive Surgery, “Sapienza” University, Policlinico Umberto I, Rome, Italy. Received May 12, 2017, and accepted for publication, after revision July 29, 2017. Conflict of interest and sources of funding: none declared. Reprints: Mr. Luigi Troisi MD, FEBOPRAS, Plastic Surgery Department, Southmead Hospital, Southmead Rd, Westbury-on-Trym, Bristol, United Kingdom. E-mail: [email protected]. Annals of Plastic Surgery: March 2018 - Volume 80 - Issue 3 - p 272-276 doi: 10.1097/SAP.0000000000001224 Buy Metrics Abstract The peroneus brevis flap was first described as proximally based by Mathes et al (Surg Clin North Am. 1974;54:1337–1354) and later by Jackson and Scheker (Injury. 1982;13:324–330). A distally based version of this flap by Mathes and Nahai (Reconstructive Surgery: Principles, Anatomy and Technique. 1997:1437e46) was subsequently described in 1997. The first case series of distally based flaps was published by Eren et al (Plast Reconstr Surg. 2001;107:1443–1448). In our experience, the distally based flap is a useful muscle flap to reconstruct small defects in the lateral distal third of the leg. Initial interest and confidence in the use of this flap in our unit were hindered by lack of direct experience and descriptive detail in the literature. We have now developed a systematic approach to harvest the distally pedicled peroneus brevis muscle flap in 5 reproducible, safe steps. This has allowed the flap to become adopted as a standard technique of limb reconstruction in our unit with no cases of flap loss. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.