The distally based peroneus brevis muscle flap—clinical series and review of the literature

The distally pedicled peroneus brevis muscle flap is rarely used for defect coverage in the distal lower leg. The purpose of this article was to present our clinical series and provide a review of the literature to analyze the overall complication rates and safety of this flap. In our clinical series of 10 patients undergoing reconstruction with the flap, one necrosis of the distal half of the flap and one necrosis of a skin graft occurred. Our review of the literature identified 192 patients undergoing reconstruction with distally pedicled peroneus brevis flaps. The overall complication rate was 41.6%. Typical indications, complications, advantages and disadvantages to alternatives are discussed. The distally pedicled peroneus brevis flap is an interesting option for soft tissue coverage in the distal lower leg. The donor site can always be closed primarily, the anatomy is constant and complication rates are comparable to alternatives in this region like the distally based sural fasciocutaneous flap.