Effects of the lateral circumflex femoral artery chimeric perforator flap in repairing composite tissue defects in the ankle and foot area

Li Hai; Deng Chengliang; Xiao Shun'e; Wu Xiangkui; Wu Bihua; Wei Zairong

doi:10.3760/cma.j.cn501225-20240202-00045

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Li Hai,Deng Chengliang,Xiao Shun’e,et al.Effects of the lateral circumflex femoral artery chimeric perforator flap in repairing composite tissue defects in the ankle and foot area[J].Chin J Burns Wounds,2025,41(4):1-8.DOI: 10.3760/cma.j.cn501225-20240202-00045.

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Effects of the lateral circumflex femoral artery chimeric perforator flap in repairing composite tissue defects in the ankle and foot area

doi: 10.3760/cma.j.cn501225-20240202-00045

Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China

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Collaborative Innovation Center of Chinese Ministry of Education 2020-39

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Corresponding author: Deng Chengliang, Email: cheliadeng@sina.com
Received Date: 2024-02-02
Available Online: 2025-03-27

Abstract

Abstract

Objective To investigate the effect of the lateral circumflex femoral artery chimeric perforator flap in repairing composite tissue defects in the ankle and foot area. Methods This study was a retrospective observational study. From January 2018 to December 2023, 12 patients with composite tissue defects in the ankle and foot area who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of the Affiliated Hospital of Zunyi Medical University. Among them, there were 9 males and 3 females, aged from 4 to 64 years. The causes of the injuries included traffic accidents in 7 cases, wringing injuries in 2 cases, crush injuries in 2 cases, and fall injury in 1 case. All patients had combined skin and soft tissue defects, with the defect areas ranging from 10.0 cm×5.0 cm to 22.0 cm×7.0 cm. Among them, 7 patients had combined ankle joint capsule defects, with the sizes ranging from 3 cm×2 cm to 6 cm×5 cm; 3 patients had combined Achilles tendon defects, with the lengths ranging from 4 to 8 cm; 1 patient had combined extensor hallucis longus tendon defect, with a length of 4 cm; 1 patient had combined extensor digitorum longus tendon defect, with a length of 10 cm. All patients underwent repair of the composite tissue defects using the lateral circumflex femoral artery chimeric perforator flap. Flaps with sizes ranging from 11.0 cm×5.5 cm to 24.0 cm×6.5 cm were used to repair skin and soft tissue defects, and fascia lata flaps with sizes ranging from 4.0 cm×2.5 cm to 17.0 cm×2.0 cm were used to repair joint capsule and tendon defects. The donor area tissue was sutured. Postoperatively, regular follow-up was conducted to observe the survival of the flaps after surgery, the repair of the defects, the healing of the incisions in the flap donor area, the occurrence of complications, the appearance and texture of the flaps, the scar formation in the surgical area, and the muscle strength and movement of the lower limb on the flap donor side. At the last follow-up, the American Orthopaedic Foot and Ankle Society scoring system was used to evaluate the function of the ankle and foot. Results All patients were followed up. The follow-up period ranged from 2 to 38 months, with an average of 8.7 months. After the operation, all flaps survived, and all wounds in the recipient areas healed. For the patients who had undergone ankle joint capsule and tendon reconstruction, there was no swelling in the joints, and the joint movements were good. There were no deformities, such as foot drop or toe drop. All incisions in the flap donor areas healed, and no complications occurred. The family members of 2 child patients felt that the flaps were bulky, and they returned their children to the hospital for flap thinning at 3 and 4 months after the operation, respectively. The other patients were satisfied with the appearance and texture of the flaps. One child patient had obvious early scar hyperplasia, and the scar gradually faded after external application of anti-scar medications and compression treatment. The scars of the other patients were not obvious. The muscle strength of the lower limbs on the flap donor side of all patients was grade 5, and the movements were normal. The functions of the ankle and foot were rated as excellent in 8 cases and good in 4 cases. Conclusions The lateral circumflex femoral artery chimeric perforator flap is flexible in design. It can repair composite tissue defects of skin and soft tissue, joint capsules, and tendons in the ankle and foot simultaneously. There are no obvious complications in the flap donor area. Most patients are satisfied with the appearance of the flap in the recipient area. The texture of the flap is soft, and the functional recovery of the ankle and foot is relatively good.
- Wounds and injuries,
- Foot,
- Microsurgery,
- Surgical flaps,
- Soft tissue defect,
- Chimeric perforator flap

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