Clinical outcomes of extended reverse sural flap in ankle and foot defect reconstruction

Background: Reconstruction of ankle and foot defects presents significant challenges due to limited local tissue availability and functional demands. The extended reverse sural flap (ERSF) has emerged as a valuable alternative to free flaps in resource-limited settings. This study evaluates the clinical outcomes of ERSF for distal lower extremity reconstruction. Methods: A prospective interventional study was conducted at Dhaka Medical College Hospital from January 2012 to June 2013. Sixteen patients with defects in the distal third of the leg, ankle, or foot secondary to trauma (machinery injuries, road traffic accidents, and burns) were included through purposive sampling. Demographic data, defect characteristics, surgical outcomes, and complications were recorded and analyzed using MS Office tools. The study received ethical approval from the institutional review board. Results: The study included 16 patients (mean age 38.25±11.84 years; 87% male) with foot and ankle defects, most commonly in the heel and sole. The extended reverse sural flap effectively covered defects (mean 98.69±38.66 cm²), with marginal necrosis in 62.5% of cases. Functional outcomes improved significantly, particularly in ankle mobility. Complications were minimal, with venous congestion observed in 18.8% of patients. Conclusion: The extended reverse sural flap is a reliable option for reconstructing ankle and foot defects, offering good functional outcomes and acceptable complication rates. It effectively covers distal defects, with improved ankle mobility, making it a valuable technique in lower limb reconstructive surgery.