• L Zheng, J Zheng, and Z G Dong.
• Department of Orthopedics, Henan Provincial People's Hospital, Zhengzhou, 450003, People's Republic of China. lzheng@kleinertkutz.com.
• Eur J Trauma Emerg Surg. 2016 Aug 1; 42 (4): 503511503-511.

IntroductionThe reconstruction of soft tissue defects with dead spaces in the heel and ankle is challenging. This article describes our experience in the reconstruction of such defects using the reverse sural flap with an adipofascial extension.MethodReverse sural flaps with an adipofascial extension were used in 26 patients with soft tissue defects in the heel (n = 24) or ankle (n = 2). Extended adipofascial tissue was utilized to fill the dead space. The sizes of the adipofascial extensions varied from 2.0 to 5.0 cm in length and 4.0 to 12.5 cm in width.ResultTwenty-three flaps survived completely, and lateral marginal necrosis occurred in three flaps. All the recipient-site wounds healed without any signs of infection. The reconstruction outcomes were excellent in 20 patients and good in 6 patients according to the criteria of Boyden et al.ConclusionThe extended adipofascial tissue of the reverse sural flap improves closure of the dead spaces in soft tissue defects of the heel and ankle and thus provides beneficial conditions for the treatment of infection and reconstruction of both the function and contour of the soft tissue defects with dead spaces in the heel and ankle.

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