Distally based peroneus brevis muscle flap for the use of reconstruction of lower third defects of leg and ankle

Peroneus brevis is a muscle in the lateral compartment of the leg which is expendable with minimal functional deficit. The objective of this study was to find out its use in the coverage of the defects of the lower third of leg and ankle. A retrospective analysis of the use of pedicled peroneus brevis muscle flaps used for coverage of defects of the lower third defects of leg and ankle between May 2022 and 2023 was carried out among 10 patients with said defects. The flaps were distally based for defects the lower third of leg and ankle. Split skin graft coverage was done in all cases. The distally based peroneus brevis muscle flap was used in a series of 10 patients with defects over the lateral malleolus (40%), anterior lower 1/3rd of tibia (40%) and tendoachilles (20%). Flap survival was 100% in all cases with 3 cases having 20% split skin graft loss. Donor site healed well in 100% of cases and no long term muscle function deficit was observed in all cases. This flap has a unique vascular pattern and falls into the type-4 muscle flap category under the Mathes and Nahai Classification. The flap is simple to raise and safe for the reconstruction of small-to moderate-sized skin defects of the distal third of the tibia and all parts of the ankle except the medial malleolus, which is too far from the pedicle of the distally based flap.