Abd-Al-Moktader Magdy Ahmed
Department of Plastic Surgery, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo, Egypt.
J Reconstr Microsurg. 2018 Oct;34(8):616-623. doi: 10.1055/s-0038-1661366. Epub 2018 Jun 28.
Peroneus brevis muscle flap is a distinguished, distally based safe flap that can be manipulated to cover small defects in the leg and ankle. For large-sized defects, a more distal, larger flap is required either locally or distantly.
Forty-two distally based peroneus brevis muscle flaps were elevated in 42 patients (30 males and 12 females) with major lower leg, ankle, and proximal foot defects of 6 to 15 cm in length and 6 to 12 cm in width. Anatomical findings were recorded as number, size, and sources of blood supply, entry sites, the lowermost two arterial supplies, internal distribution of blood supply to the muscle, the relationship between external and internal distribution of the blood vessels, the length of the muscle, the entry site of the main artery, and the splitting of the proximal portion of the peroneus brevis muscle to increase its width to sufficiently cover large defects.
The anatomical findings suggested that the muscle can be safely extended to cover a large defect in the leg, ankle, or proximal foot. In addition, the longitudinal splitting of the muscle increases its width by up to three times, making it an excellent long-surviving flap to cover a large defect.
A distally based peroneus brevis muscle flap has a rich blood supply and safely reaches the proximal foot, with a secure splitting to cover large defects in the leg, ankle, and proximal foot.
腓骨短肌肌瓣是一种独特的、以远侧为蒂的安全肌瓣，可用于覆盖小腿和踝关节的小面积缺损。对于大面积缺损，则需要在局部或远处采用更靠远侧、更大的肌瓣。
对42例（男30例，女12例）小腿、踝关节及足近端存在大面积缺损（长度6至15厘米，宽度6至12厘米）的患者掀起42个以远侧为蒂的腓骨短肌肌瓣。记录解剖学发现，包括血供的数量、大小和来源、进入部位、最下方的两支动脉供血、肌肉内部血供分布、血管外部与内部分布的关系、肌肉长度、主要动脉进入部位，以及腓骨短肌近端的劈开情况以增加其宽度，从而充分覆盖大面积缺损。
解剖学发现表明，该肌瓣可安全延伸以覆盖小腿、踝关节或足近端的大面积缺损。此外，肌肉的纵向劈开可使其宽度增加达三倍，使其成为覆盖大面积缺损的优良、存活时间长的肌瓣。
以远侧为蒂的腓骨短肌肌瓣血供丰富，可安全抵达足近端，通过可靠的劈开可覆盖小腿、踝关节及足近端的大面积缺损。
