Introduction. Soft tissue coverage of distal leg and ankle region represents a challenge and such defect usually requires a free flap.\nHowever, this may lead to considerable donor site morbidity, is time consuming, and needs facility of microsurgery.With the introduction\nof perforator flap, management of small- and medium-size defects of distal leg and ankle region is convenient, less time\nconsuming, and with minimal donor site morbidity.When local perforator flap is designed as propeller and rotated to 180 degree,\ndonor site is closed primarily and increases reach of flap, thus increasing versatility. Material andMethods. From June 2008 toMay\n2011, 20 patients were treated with perforator-based propeller flap for distal leg and ankle defects. Flap was based on single perforator\nof posterior tibial and peroneal artery rotated to 180 degrees. Defect size was from 4 cm Ã?â?? 3.5 cm to 7 cm Ã?â?? 5 cm. Results. One\npatient developed partial flap necrosis, which was managed with skin grafting. Two patients developed venous congestion, which\nsubsided spontaneously without complications. Small wound dehiscence was present in one patient. Donor site was closed primarily\nin all patients. Rest of the flaps survived well with good aesthetic results. Conclusion. The perforator-based propeller flap for\ndistal leg and ankle defects is a good option. This flap design is safe and reliable in achieving goals of reconstruction. The technique\nis convenient, less time consuming, and with minimal donor site morbidity. It provides aesthetically good result.
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