Adipofascial Flap Cover For Medial Maleolus Defect

Year : 2025 | Volume : 14 | Issue : 01 | Page : 6 10
    By

    Nareshkumar Codandabany,

  • RaviKumar Chittoria,

  1. Consultant, Department of Plastic Surgery, Sri Narayani Hospital and Research CentreSripuram,Vellore, Tamil Nadu, India
  2. Professor of Plastic Surgery, JIPMER, Puducherry, India

Abstract

Soft tissue defects in the lower third of the leg, particularly over the medial malleolus, pose significant challenges due to poor vascularization and the limited availability of reliable local flaps. Over the past two decades, free tissue transfer has emerged as the preferred option for covering such defects. However, in certain cases, free flap transfer is not feasible due to patient-specific factors, cost constraints, or donor site morbidity. Traditional pedicled fasciocutaneous flaps, though effective, often result in significant donor site complications and suboptimal cosmetic outcomes. In this case report, we present the use of an anterior tibial artery perforator-based adipofascial flap to cover a post-traumatic defect over the medial malleolus in a 27-year-old male patient. The defect involved an exposed medial malleolus with periosteal loss and surrounding skin damage. This alternative approach minimizes donor site morbidity, preserves function, and improves aesthetic outcomes. Following the flap transposition, a split-thick skin graft was applied to complete the reconstruction. The procedure proved to be a viable option for managing soft tissue defects in the distal leg, combining simplicity, cost-effectiveness, and improved cosmetic results. This technique can serve as a valuable alternative for cases where free flaps or other local flaps are unsuitable.

Keywords: Adipofascial flap; Anterior tibial artery perforator; Medial malleolus defect; Lower limb reconstruction; Soft tissue coverage; Split-thickness skin graft; Donor site morbidity; post-traumatic ankle defect.

[This article belongs to Research and Reviews : Journal of Surgery ]

How to cite this article:
Nareshkumar Codandabany, RaviKumar Chittoria. Adipofascial Flap Cover For Medial Maleolus Defect. Research and Reviews : Journal of Surgery. 2025; 14(01):6-10.
How to cite this URL:
Nareshkumar Codandabany, RaviKumar Chittoria. Adipofascial Flap Cover For Medial Maleolus Defect. Research and Reviews : Journal of Surgery. 2025; 14(01):6-10. Available from: https://journals.stmjournals.com/rrjos/article=2025/view=197680


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Regular Issue Subscription Original Research
Volume 14
Issue 01
Received 17/12/2024
Accepted 10/01/2025
Published 10/01/2025
Publication Time 24 Days
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