Two propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case report

Soft tissue defects in the lower leg often represent a therapeutic challenge. One of the treatment modalities is plastic reconstruction with a propeller flap. In our case report, we would like to present a case of a 75-year-old, multimorbid female patient who developed in the right distal lower leg,...

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Main Authors: Adam Stepniewski, Alperen Sabri Bingoel, Katharina Jäckle, Wolfgang Lehmann, Gunther Felmerer
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JPRAS Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352587825000506
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author Adam Stepniewski
Alperen Sabri Bingoel
Katharina Jäckle
Wolfgang Lehmann
Gunther Felmerer
author_facet Adam Stepniewski
Alperen Sabri Bingoel
Katharina Jäckle
Wolfgang Lehmann
Gunther Felmerer
author_sort Adam Stepniewski
collection DOAJ
description Soft tissue defects in the lower leg often represent a therapeutic challenge. One of the treatment modalities is plastic reconstruction with a propeller flap. In our case report, we would like to present a case of a 75-year-old, multimorbid female patient who developed in the right distal lower leg, both medial and lateral, soft tissue defects after open reduction and internal fixation of a complex ankle fracture. She was treated by the single surgeon with two propeller flaps, one lateral and one medial, in the same operation.With this single-stage procedure, we achieved effective, long-term closure of the defect. It resulted in several advantages for the patient, including a shorter operation time compared to hypothetic two free flaps and no additional prolonged anesthesia. Also, defects were reconstructed according to the “like with like” principle, and less donor site morbidity compared to free muscle flaps. The disadvantage of the procedure was the need for split skin graft of the donor sites. Based on our experience, this method could be an option for carefully selected patients without high aesthetical demands who have undergone appropriate preoperative systemic and local optimization.
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spelling doaj-art-9566766320bf4dbea15b7ac05d2ff3792025-08-20T02:26:09ZengElsevierJPRAS Open2352-58782025-06-014421221610.1016/j.jpra.2025.03.006Two propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case reportAdam Stepniewski0Alperen Sabri Bingoel1Katharina Jäckle2Wolfgang Lehmann3Gunther Felmerer4Division of Plastic Surgery, Department for Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Göttingen, 37075 Göttingen, Germany; Corresponding author.Division of Plastic Surgery, Department for Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Göttingen, 37075 Göttingen, GermanyDepartment for Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Göttingen, 37075 Göttingen, GermanyDepartment for Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Göttingen, 37075 Göttingen, GermanyDivision of Plastic Surgery, Department for Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Göttingen, 37075 Göttingen, GermanySoft tissue defects in the lower leg often represent a therapeutic challenge. One of the treatment modalities is plastic reconstruction with a propeller flap. In our case report, we would like to present a case of a 75-year-old, multimorbid female patient who developed in the right distal lower leg, both medial and lateral, soft tissue defects after open reduction and internal fixation of a complex ankle fracture. She was treated by the single surgeon with two propeller flaps, one lateral and one medial, in the same operation.With this single-stage procedure, we achieved effective, long-term closure of the defect. It resulted in several advantages for the patient, including a shorter operation time compared to hypothetic two free flaps and no additional prolonged anesthesia. Also, defects were reconstructed according to the “like with like” principle, and less donor site morbidity compared to free muscle flaps. The disadvantage of the procedure was the need for split skin graft of the donor sites. Based on our experience, this method could be an option for carefully selected patients without high aesthetical demands who have undergone appropriate preoperative systemic and local optimization.http://www.sciencedirect.com/science/article/pii/S2352587825000506Propeller flapFree flapLower legSoft tissue defectAnkle fractureReconstruction
spellingShingle Adam Stepniewski
Alperen Sabri Bingoel
Katharina Jäckle
Wolfgang Lehmann
Gunther Felmerer
Two propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case report
JPRAS Open
Propeller flap
Free flap
Lower leg
Soft tissue defect
Ankle fracture
Reconstruction
title Two propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case report
title_full Two propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case report
title_fullStr Two propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case report
title_full_unstemmed Two propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case report
title_short Two propeller flaps in a distal lower leg with bilateral defects as a single-stage procedure: A case report
title_sort two propeller flaps in a distal lower leg with bilateral defects as a single stage procedure a case report
topic Propeller flap
Free flap
Lower leg
Soft tissue defect
Ankle fracture
Reconstruction
url http://www.sciencedirect.com/science/article/pii/S2352587825000506
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AT katharinajackle twopropellerflapsinadistallowerlegwithbilateraldefectsasasinglestageprocedureacasereport
AT wolfganglehmann twopropellerflapsinadistallowerlegwithbilateraldefectsasasinglestageprocedureacasereport
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