Distally based peroneus brevis flap: Reconstruction of complex soft-tissue defects with bony infection of the lateral malleolus

Background: Managing wounds of the lateral malleolus is challenging owing to limited nearby tissues and possibly injured or inadequate vessels for free flaps, especially in case of underlying infections. Moreover, free flaps require specialized skills and are not suitable for every patient. Therefore, identifying reliable local alternatives is crucial. This retro - spective study investigated the efficacy and safety of the distally based peroneus brevis muscle flap in treating complex and infected soft -tissue defects of the lateral malleolus. Materials and methods: A retrospective medical chart review of all patients who underwent a distally based peroneus brevis muscle flap reconstruction in the context of an infected lateral malleolus defect at Geneva University Hospitals between October 2020 and January 2024 was performed. Results: Ten patients underwent lateral malleolus reconstruction using a distally based per - oneus brevis muscle flap primarily to address post -traumatic infections. Flap coverage was performed within 4 weeks of infection onset for post -traumatic cases, alongside antibiotic treatment. The defects were moderate in size, with a median width of 2.5 cm and length of 5.5 cm. There were no complete or partial flap failures. All patients regained the ability to walk within 5 days after surgery. Conclusions: The distally based peroneus brevis muscle flap was efficient in managing complex and infected soft -tissue defects of the lateral malleolus, with control of infection in all patients and minimal donor -site morbidity. (c) 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creative - commons.org/licenses/by/4.0/ ).