2000 Volume 49 Issue 1 Pages 228-231
We successfully treated skin defects around the ankle joint by the reverse venoneuroadipofascial (V-NAF) flap in 2 patients. The V-NAF flap is the fasciocutaneus flap supplied by accompanying arteries of the cutaneous vein and cutaneous nerve. Case 1 was a 54-year-old female suffering rheumatoid arthritis for 30 years. Intractable ulcer at the medial malleolar region of the right ankle joint occurred 2 years ago and has enlarged. The skin defect was covered with reverse V-NAF flap (16×6cm) and the donor site was covered with skin graft. No recurrence of the ulcer was found for 5 months. Case 2 was a 23-year-old male with 50 degrees equinus contracture of the left ankle after rupture of the popliteal artery. He received ankle fusion and developed skin defect in front of the ankle joint. This defect was covered with V-NAF flap (10×5cm) and the donor site closed primarily. Wounds healed without any problems. The reverse V-NAF flap is considered the treatment of choice to cover skin defects around the ankle joint. The advantages of this flap are as follows; it is reliable, there is no need for microvascular anastomosis, and harvesting is easy without the need to sacrifice major arteries.
