Complications of Lateral Calcaneal Flap for Posterior Heel Defects

Background: The lateral calcaneal artery skin flap is preferred by many surgeons for posterior heel reconstruction, as it covers difficult wounds effectively. It does not require sacrificing a major artery in the leg or foot and is relatively thin, with acceptable morbidity at the donor site. Objective: To determine the frequency of complications of lateral calcaneal flap for posterior heel defects. Methodology: This descriptive study was conducted at the Department of Plastic Surgery, Lady Reading Hospital Peshawar, after obtaining ethical approval. A total of 126 patients, aged 18-60 years of either gender, with posterior heel defects, were included. Patients with comorbidities or wounds due to malignant resections were excluded from the study. Results: This study included 126 patients with a mean age of 38.6±10 years, consisting of 57% males and 43% females. Trauma was the leading cause of injury, (48% wheel spokes injury). The mean defect size was 3.8±0.7 cm, and flap size ranged from 3.1 - 5.1 cm (p < 0.001). The most common complication was dog ear deformity (39.7%), followed by epidermal necrosis (12.7%) and partial skin graft loss (19.8%). No significant associations were found between complications and age, gender. Rural area residence was found to be independent predictor of complications (odds ratio of 2.1, 95% CI: 1.1–4.0, p = 0.032). Conclusion: The lateral calcaneal artery skin flap can be used safely to provide sensory skin coverage to the posterior heel in one stage with minimal complications and acceptable donor site morbidity.