Peroneal Artery "Terminal" Perforator Pedicled Flap for Surrounding Soft Tissue Defects: A Retrospective Cohort Study.

Purpose: To introduce a technique to reconstruct soft tissue defects around the space of lateral malleolus by using the peroneal artery "terminal" perforator flap (the lowest perforating branch of the peroneal in the posterior compartment artery of lateral malleolus), and to report its effectiveness. Methods: From January 2018 to April 2020, 7 patients with soft tissue defects around the space of lateral malleolus were treated with the peroneal artery "terminal" perforator flap. Ultrasound was used to determine the perforating site of the peroneal artery. The lowest perforating branch adjacent to the wound margin was used as the rotation point to design the peroneal artery perforator flap. Results: One case had venous crisis. However, no urgent operative revision was performed. All of the 7 flaps survived completely. The grafted skins at donor site survived, and primary healing of incision was obtained. The follow-up period was 6 to 17 months with an average of 10.7 months. The flaps exhibited favorable color, texture, and overall appearance. The ability to wear shoes remained unaffected, and ankle mobility was not restricted. Surgeries for thinning the flaps were not necessary. All of the patients were satisfied with the cosmetic and functional result. Conclusion: The peroneal artery terminal perforator flap is a useful and reliable choice for coverage of soft tissue defects around the space of lateral malleolus in clinical application.