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Erschienen in: Journal of Orthopaedic Science 5/2013

01.09.2013 | Original Article

Clinical and anatomical study of the distally based lesser saphenous veno-lateral sural neurocutaneous flap for lower extremity coverage

verfasst von: Huijie Gu, Zhuyou Xiong, Jing Xu, Guangzao Li, Chen Wang

Erschienen in: Journal of Orthopaedic Science | Ausgabe 5/2013

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Abstract

Background

The distally based sural flap has been widely and successfully used to reconstruct soft tissue defects of the distal third of the lower leg and foot. Sensory loss and venous congestion are possible complications of this treatment, but there has been limited research focused on improving the sensory loss and veneous congestion. This study aimed to determine the spatial relationship between the lesser saphenous vein and the cutaneous nerves, the venous anatomy in the lower leg, and the nerve distribution in the lateral dorsum of the foot, and we presented our clinical experience.

Materials and methods

Twenty freshly amputated lower limbs were dissected in the 2 h following amputation. The lesser saphenous vein, medial/lateral sural nerve, and sural nerve were identified. Based on the anatomical studies, an island flap supplied by the vascular axis of the lesser saphenous vein and the lateral sural nerve was designed for clinical reparative applications in 24 cases.

Results

We indicated the spatial relationship between the lesser saphenous vein and the cutaneous nerves and the venous anatomy in the lower leg. Among 24 flaps, 21 showed complete survival (87.5 %), while marginal flap necrosis occurred in two patients (8.33 %) and distal wound dehiscence in another (4.17 %). No symptomatic neuromas were observed. Their appearance and functioning were satisfactory, with filling maintained in the heel and lateral side of the foot.

Conclusion

The distally based lesser saphenous veno-lateral sural neurocutaneous flap provides effective coverage of variable-sized soft tissue defects on the lower third of the lower leg and foot, without sensory loss and venous congestion.
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Metadaten
Titel
Clinical and anatomical study of the distally based lesser saphenous veno-lateral sural neurocutaneous flap for lower extremity coverage
verfasst von
Huijie Gu
Zhuyou Xiong
Jing Xu
Guangzao Li
Chen Wang
Publikationsdatum
01.09.2013
Verlag
Springer Japan
Erschienen in
Journal of Orthopaedic Science / Ausgabe 5/2013
Print ISSN: 0949-2658
Elektronische ISSN: 1436-2023
DOI
https://doi.org/10.1007/s00776-013-0434-x

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