What is it about?

There have been very limited data on the use of pedicled peroneal artery perforator flaps in knee soft-tissue reconstruction, especially for anterior and medial defects. The different factors accepting flap reach were further illustrated

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Why is it important?

It shows the versatility of Pedicled Peroneal Artery Perforator Flap for knee defect reconstruction with detailed assessment of the different factors related to flap reach

Perspectives

The challenges associated with flap harvest and reach were shown The abstract of the paper as follow: There have been very limited data on the use of pedicled peroneal artery perforator flaps in knee soft-tissue reconstruction, especially for anterior and medial defects. Here, we present a case of proximally based peroneal artery perforator flap for knee soft-tissue reconstruction in a defect that included lateral, anterior, and medial surfaces of the knee presenting the technical challenges associated with this flap. A 15-year-old girl presented with extruded knee implant after osteosarcoma resection of femur. The defect involved the whole knee with the anterior and mostly the lateral knee surfaces. Her medical condition precluded the use of free tissue transfer. During her previous surgery, gastrocnemius muscles were detached with injured vascular pedicled and posterior tibial artery. Successful single-stage coverage was achieved using a large proximally based pedicled peroneal artery perforator flap. There are only few reports that described the use of peroneal artery flaps for knee soft-tissue coverage. The reach of a proximally based flap can be increased when it is raised on a distal perforator or when peroneal artery has a proximal takeoff. Furthermore, removing the fibula can facilitate the dissection and the reach of the flap till the most medial aspect of the knee. Pedicled peroneal artery perforator flap provides superior soft-tissue coverage with limited morbidity for knee soft-tissue reconstruction; however, flap reach is usually affected by anatomic variation. Preoperative planning can help to determine the reach of the flap and ease the dissection.

Dr feras alshomer
King abdullaziz medical city

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This page is a summary of: Pedicled Peroneal Artery Perforator Flap for Knee Defect Reconstruction, Plastic and Reconstructive Surgery Global Open, November 2018, Wolters Kluwer Health,
DOI: 10.1097/gox.0000000000002034.
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