It was with great pleasure that we read the comment of Lorenzetti et al. on our article describing the clinical experience with 109 peroneus brevis flaps in various versions and about their own use of this flap as a muscle flap. They describe their experience in using the distally pedicled muscular flap as one of their standard flaps.1 We congratulate the authors for their interesting and very recent study and are delighted to hear that they also describe very positive results of this relatively simple flap for many small and medium defects around the ankle. This exactly parallels our experience if some details during dissection are followed, as described in our original article.2
We are grateful that Lorenzetti et al. reinforce our positive experience with the very low donor-site morbidity of the flap with objective data they have gathered evaluating postoperative foot and ankle mobility with both the Weber Demerit and the Olerud-Molander Ankle Scores. No deterioration in either score was observed after having harvested the peroneus brevis flap. Using these scores on our compound osteomuscular flap cases would certainly be very interesting as soon as we have a larger number of those skeletal reconstruction cases. In providing us their experience here, they combine the clinical experiences from both our both groups with a considerable number of flaps and will surely encourage more reconstructive surgeons to choose the peroneus brevis flap for defects in its typical arc of rotation.
Goetz A. Giessler, M.D., Ph.D.
Andreas B. Schmidt, M.D.
Department of Plastic, Hand, and Reconstructive Microsurgery
BG Trauma Center Murnau
1. Lorenzetti F, Lazzeri D, Bonini L, et al. Distally based peroneus brevis muscle flap in reconstructive surgery of the lower leg: Postoperative ankle function and stability evaluation. J Plast Reconstr Aesthet Surg
2. Schmidt AB, Giessler GA. The muscular and the new osteomuscular composite peroneus brevis flap: Experiences from 109 cases. Plast Reconstr Surg
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