The proximally based long peroneal muscle turnover flap: A novel salvage flap for small to medium-sized defects of the knee

SummaryBackground and aimCoverage of soft-tissue defects of the knee due to multiple operations, trauma, and infection remains a surgical challenge. Often, these defects are repaired using free tissue transfer. The aim of this study was to find an easy and reliable local method of repair for small to medium-sized defects. The authors describe a new surgical option for tissue coverage using a proximally based long peroneal muscle turnover flap (LPTF) with split-thickness skin graft.MethodsProximally based LPTFs were harvested and transposed into same-size created defects in five cadavers. After optimizing this technique, it was clinically used in two patients with defects secondary to total knee replacement revisions.ResultsAverage cadaver flap size was 4.7 × 15.8 cm allowing reach of all knee joint areas and was based consistently on a sufficient (2-mm-diameter average) proximal arterial branch of the anterior tibial artery. Donor sites were closed without tension. Subsequent application of the flap on two patients resulted in good functional outcome.ConclusionThe proximally based LPTF is a new option available in the reconstruction of knee defects and should be added to the reconstructive surgeon's armamentarium of pedicled flaps, providing short operating time and promising clinical outcome.