Clinical application of the adipofascial turnover flap in the leg and ankle.

In soft-tissue defects with bone exposure over the leg and ankle, it is often impossible to achieve wound closure by a simple skin graft. In this article, we present a simple and effective way to reconstruct complicated skin defects on the pretibial region (four patients), the ankle (three patients), the distal fibula (one patient), and the medial aspect of the leg (one patient). Dissection of the local adipofascial turnover flap is quite easy and quick, requires less time, and involves less risk to the patient. It can be completed as a single-stage procedure, and no muscle function or major artery must be expended. Although there are numerous options for reconstruction of soft-tissue defects of the leg and ankle, the nonbulky adipofascial turnover flap appears particularly indicated for small- to medium-sized defects. The contours of the recipient and donor sites are acceptable aesthetically. Adequate flap-to-base area ratio and length-to-width ratio, tension-free insetting of the flap, and noncompression dressing are essential for the flap's survival.