ArticleInternational journal of surgery case reports2026
Subfascial-cutaneous propeller flap for reconstruction of chronic distal lower-limb wounds with exposed bone: two-case reports.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction and importance: Propeller perforator flaps provide a reliable reconstructive option for distal lower-limb soft-tissue defects, particularly in resource-limited settings where microsurgical free-flap reconstruction may not be readily available. These cases highlight the practical application of propeller perforator flaps in a low-resource setting, demonstrate key surgical decision-making processes, illustrate the management of flap-related complications, and report favorable functional outcomes following reconstruction of complex distal lower-limb wounds. Case presentation: We present two patients with distal lower-limb wounds and exposed bone: a 33-year-old man with a post-traumatic medial malleolar defect reconstructed using a posterior tibial artery perforator propeller flap, and a 13-year-old boy with a chronic distal anterior leg wound secondary to osteomyelitis reconstructed using a superficial peroneal artery perforator propeller flap. Both patients had no significant comorbidities. Minor complications, including partial flap necrosis and venous congestion, were successfully managed conservatively. At the 2-month follow-up, both patients achieved satisfactory wound coverage, preservation of limb function, and acceptable cosmetic outcomes. Clinical discussion: Propeller perforator flaps provide effective reconstruction for complex distal lower-limb defects. Compared with free flaps, they offer a reliable, low-morbidity reconstructive option, particularly in resource-limited settings. Complications such as venous congestion and partial flap necrosis may occur but can often be successfully managed with conservative measures. Conclusion: Propeller perforator flaps are a reliable and effective option for reconstruction of distal lower-extremity soft-tissue defects, providing durable coverage while preserving major vascular structures and minimizing donor-site morbidity. These flaps represent a valuable alternative to local rotational and microsurgical free flaps, particularly in resource-limited settings.
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