Repairing Pretibial and Foot Soft Tissue Defects With Reverse Transplantation of the Medial Crural Fasciocutaneous Flap

Abstract

Soft tissue defects of the pretibial area and the foot are among the most common complications in patients with lower extremity injuries and remain a challenge for surgeons. This study examined the clinical effects of repairing pretibial and foot soft tissue defects with a medial crural fasciocutaneous flap. Twenty-three injury cases with soft tissue defects in the middle/lower parts of the tibia and ankle/heel were treated. Of these, 8 injuries were in the lower pretibial region, 11 injuries were in the heel, and 4 injuries were in the dorsalis pedis. The dimensions of the soft tissue defects ranged from 7 cm × 5 cm to 18 cm × 10 cm. The crural fasciocutaneous flap was used for wound repair in all cases. The skin harvest dimensions ranged from 12 cm × 6 cm to 23 cm × 12 cm, and the width of the reverse flap pedicle was greater than 4 cm. The patients were followed up for 6 to 27 months postsurgery. All flaps survived and appeared healthy, and leg function was satisfactorily recovered. Five patients suffered from distal flap necrosis and 2 patients suffered from effusion. The area of the crural fasciocutaneous flap harvest appeared to have a good blood supply, and the procedure was easy to perform without injuries to the main vasculature. In conclusion, the medial crural fasciocutaneous flap is a safe and effective clinical intervention for the reconstruction of soft tissue defects of the pretibial area and foot.