Vol. 8, Issue 7, Part E (2022)

Abstract
Background: Reconstruction of soft tissue defects related to the perimalleolar region is a challenging problem due to bony prominences and lack of local soft tissue. Treatment options are limited in reconstruction of this region. Local flap covers are safe alternatives to free flaps in patients with lower extremity injuries and they provide fast and simple options for managing difficult to reconstruct wounds.Methods: We conducted a retrospective analysis of 23 post-traumatic patients using a regional flap cover. We used different flap options for the patients based on availability of the perforators and soft tissue for cover of defects and surgeons preference for the flap cover. We included all patients with post-traumatic defects in perimalleolar regions for which loco-reional flaps were available. We excluded patients with large defects for which free flaps were needed or local flap options were not available.Results: Our series includes 23 post-traumatic perimalleolar defects, for 20 defects we performed perforator based pedicled fasciocutaneous flap cover and 3 defects were covered with pedicled muscle flap with skin-grafting. Uneventful primary healing was recorded in 21 patients. A complication occurred in our 2 patients; in one patient there was partial skin graft loss and in another patient there was partial flap necrosis of propeller flap, due to venous insufficiency, that required secondary skin grafting.Conclusions: Choice of the local flap cover for perimalleolar defects should be based on size and location of the flap, limitations related to available flap options and surgeons preference of flap cover.