Clinical Application Of Peroneal Artery Perforator Flap With Gastrocnemius Aponeurosis In Repair Of Lower Extremity Soft Tissue Defects

[Objective]To observe and evaluate the clinical effect of peroneal artery perforator flap with gastrocnemius aponeurosis in the repair of lower extremity soft tissue defects and provide theoretical basis for further clinical application.[Methods]This study retrospectively analyzed 16 patients with skin and soft tissue defects of lower extremity,who were admitted to the orthopaedic department of our hospital from July 2017 to December 2018,including 10 males and 6 females with the age range of 18-52 years and the average age of(36.5±8.9)years.The range of skin defect was 4.5cm*7cm～8cm*11cm.The mean follow-up time was(12.4±5.2)months.The perforating branch flap of peroneal artery with gastrocnemius aponeurosis was cut to repair the wounds.The skin flap status,sensory function scale So-Ss,ankle plantar flexion and dorsiflexion(AOFAS)and dorsiflexion were evaluated postoperatively.The MOS item short from health survey(SF-36)was used to evaluate the quality of life of the patients.[Results]The flaps survived completely and the wound healed in one stage in 13 cases.The complete survival rate was 81.25%.Postoperative complications included hyperplastic scar in 4 cases,pigmentation in 6 cases,numbness in 6 cases,and pain abnormality in 5 cases.At 12 months postoperatively,the results of skin flap sensory test were S1 in 8 patients,S2 in 6 patients and S3 in 2 patients.The postoperative metatarsophalangeal flexion and dorsiflexion of ankle at 3 months and 12 months were significantly higher than preoperative ones(P<0.05).The AOFAS scores at 3 months and 12 months postoperatively were respectively(73.5±8.2)(P<0.001)and(91.3±10.6),which were significantly higher than preoperative ones(P<0.05).The SF-36 scores at 3 and 12 months postoperatively were significantly higher than preoperative ones(P<0.05).[Conclusion]The sural artery perforator flap with gastrocnemius aponeurosis can repair the soft tissue defect of lower extremity.The flap has high survival rate,few complications,good sense of repair site and joint function recovery.The patient’s quality of life is significantly improved.Therefore,The flap is worthy of clinical application.