Background: Reconstruction of the lower leg and ankle
soft tissue defects is not that the convenient task, due to the
unique anatomy and its variation.
Aim of Study: Evaluation efficacy of the Free-Style,
Perforator-Plus flap concepts in the reconstruction of the soft
tissue defects at lower two-thirds leg, tendo-Achilles and
ankle regions.
Method: A Prospective (Case Series) Study, was carried
on 20 consecutive patients, which performed at the Plastic
and Reconstructive Surgery Unit of General Surgery Department
of Benha University Hospitals, and Department of Plastic
and Reconstructive Surgery at Nasser Institute for Research
and Treatment in the period from June 2020 to June 2021.
Results: 20, consecutive, exclusively males, patients, aged
from 3 to 57 years old (Mean 28±12 SD years), had a “Free-
Style, Perforator-Plus Flap" reconstructive surgery, to cover
defects presented at lower Leg two-thirds (75% of cases),
Tendo-Achilles (10%) and Ankle (15%) regions. Flap complications
were encountered in 4 cases (20%): 2 cases (10%)
had distal congestion, the other 2 cases had distal ischemia,
which one of them developed full-thickness distal loss. The
final recipient outcome “Defect Coverage" was achieved in
all cases (100%).
Conclusion: The Free-Style, Perforator-Plus Flap is reliable
with relative efficiency, versatile, and has a modest rate of
failure and need for secondary surgery. It capable to reconstruct
small to relatively large, complex defects (exposed bone or
hardware and chronic osteomyelitis) in the distal Leg twothirds,
Tendo-Achilles, and Ankle regions.