Anatomical Study of the Anastomosis Stations of Lateral Supramalleolar Artery Flap and Its Application in the Reconstruction of Distal Leg, Ankle, and Dorsum of Foot Defects
Year: 2025
Type: article
Abstract: A study was conducted to reveal the anatomy of the perforators and stations of anastomosis of the lateral supramalleolar artery (LSMA) axis and to analyze the outcome of various avatars of the flap based on the LSMA axis. Ten cadaveric dissections were performed to study the anatomy of the LSMA axis. Twenty patients with distal third leg, ankle, and dorsum of foot defects underwent reconstruction using the various avatars of the LSMA axis flaps. At the end of the follow-up, they were all assessed using the Institutional Functional and Aesthetic Outcome Assessment scoring system by two independent observers. The cadaveric study showed consistent anatomical details of superficial peroneal nerve artery-LSMA-descending branch of ramus perforans anastomotic axis and their perforators. In the clinical study, the average size of the primary defect was 63.6 cm2. The average follow-up period was 12.5 months. Three (15%) noncritical complications were reported in our study, which were all managed conservatively. Fifty-five percent (n = 11) of patients had a good/excellent final computed institutional assessment score (p = 0.025). The rest of the patients (45% [n = 9]) had a fair outcome score. Reconstructing soft tissue defects in the distal third of leg, ankle, and foot presents a considerable challenge. The LSMA flap and its various avatars may be a useful addendum in the reconstructive armamentarium for coverage of distal third leg, ankle, and dorsum foot defects.
Authors: Thalavirithan Margabandu Balakrishnan, U. Raseedha Begum, Madhuvanti Sarada Bharathwaj, Madhumitha S., Pavithra Thangavel, M. Sugumar
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410529607