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Distally Based Lateral Supramalleolar Adipofascial Flap for Reconstruction of the Dorsum of the Foot and Ankle

Lee, Young Ho M.D.; Rah, Soo Kyoon M.D.; Choi, Soo Joong M.D.; Chung, Moon Sang M.D.; Baek, Goo Hyun M.D.

Plastic and Reconstructive Surgery: November 2004 - Volume 114 - Issue 6 - p 1478-1485
doi: 10.1097/01.PRS.0000138751.53725.67

Soft-tissue reconstruction of the dorsum of the foot and ankle has long been a challenge for reconstructive surgeons. Limitations in the available local tissue and donor-site morbidity restrict the options. In an effort to solve these difficult problems, the authors have begun to use a distally based lateral supramalleolar adipofascial flap. This report presents the authors’ early experience with seven patients treated with this flap. The patients’ ages ranged from 5 to 26 years; four of the patients were male and three were female. The cause of the soft-tissue defects involved acute trauma and chronic scar contracture. The flap and the adjoining raw area were covered with a full-thickness skin graft, and the donor site at the lateral aspect of the leg was closed primarily without grafting. A skin graft was taken from the groin area, which was closed primarily. Compared with the other flaps, this adipofascial flap was thinner and produced less bulkiness to the recipient site and minor aesthetic sequelae to the donor site. It is believed that this flap is versatile and effective and is a good addition to the available techniques used by reconstructive surgeons for coverage of the dorsum of the foot and ankle.

Bucheon and Seoul, Korea

From the Departments of Orthopedic Surgery at Soonchunhyang University College of Medicine, Hallym University College of Medicine, and Seoul National University College of Medicine.

Received for publication September 18, 2003; revised December 10, 2003.

Goo Hyun Baek, M.D., Department of Orthopedic Surgery, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea,

©2004American Society of Plastic Surgeons