Reconstruction of Middle and Distal Third Crus Defects with Peroneal Artery Perforator Flap

Objectives: Reconstruction of lower extremity soft tissue defects, which may occur due to various reasons, is challenging. Although different methods have been described in lower extremity reconstruction, the peroneal artery perforator flap has unique advantages. This study aims to present the use of the peroneal artery perforator flap, which is gaining popularity day by day, to treat crus defects.
Methods: Twelve patients with middle or distal third crus defects who underwent reconstruction with peroneal artery perforator flaps were included in the study. The patients were evaluated according to age, gender, etiology, complications, defect area, and defect and flap size. The etiology included chronic wounds in one patient, trauma in six, and tumors in five. Among the patients diagnosed with tumors, two had squamous cell carcinoma, two had malignant melanoma, and one had dermatofibrosarcoma protuberans.
Results: The average age of the patients was 45.9 years. Four of the patients were female, and eight were male. Nine of the defects were located in the middle third of the crus, and three were distal. The flaps ranged in size from 78 to 210 cm². Venous insufficiency was observed in two flaps, and partial necrosis developed distally in one of them. All flaps survived.
Conclusion: The peroneal artery perforator flap is a versatile option that can be used in the middle and distal parts of the crus.

Keywords: Lower extremity, perforator, peroneal artery, propeller, reconstruction