The distally based lateral adipofascial flap.

The distally based lateral adipofascial flap can be based either on the lowermost perforator or the anterior perforating branch of the peroneal artery avoiding sacrifice of the main peroneal artery. It has been used successfully to resurface soft tissue defects either on the lateral or medial aspect of the lower third of the leg in 13 cases. The size of these flaps varied from 2.0 cm x 5.0 cm to 4.5 cm x 15.0 cm in size. These cases had minimal donor site morbidity and had positive aesthetic results. The advantages were: 1. Choice of either the lowermost perforator or the anterior perforating branch giving a wide arc of rotation; 2. Preservation of the superficial peroneal nerve; 3. Primary closure of the donor site.