Variabilidad en el diseño y composición del colgajo de perforante de tibial posterior para la reconstrucción de defectos en la pierna.

Lower extremity defects, specially lower third defects, keep being a true challenge in Reconstructive Surgery, since nearness damaged tissues, due to the traumatism or to the concomitant edema, are not suitable for the coverage of bone, tendons or exposed osteosynthesis material. Propeller flap has become an elegant and mobile method for the coverage of this type of lower extremity defects. It provides us with locorregional tissue with no vascular involvement in the traumatism and/or subsequent injury. Unlike conventional rotation or transposition flaps, direct closure of the donor site is possible, offering an optimum aesthetic result. Moreover, the presence of more proximal perforators allows the use of muscular and tendinous cuffs in the same flap to solve more complex defects, becoming something more than a free flap alternative. We present a serie of 43 patients to describe the reconstructive possibilities of the tibialis posterior perforator flap in its propeller form, as for design variability and composed flap use, with the aim of minimizing donor site morbility even more without the use of grafts. [ABSTRACT FROM AUTHOR]