Motorbike Spoke-Wheel Injuries of the lower limb treated with Fascio-Cutaneous Sural Artery Flap at a Tertiary Care Hospital

Objective: To determine the efficacy of reverse fascio-cutaneous sural artery flap in the treatment of heel pad injuries due motorbike spoke-wheel trauma. Methods: This descriptive study was conducted in Department of Orthopedic Surgery and Department of Plastic Surgery Liaquat University of Medical and Health Sciences, Jamshoro, Sindh from 15th October 2017 to 15th December 2019. All adults patients of either gender and age with motorbike spoke-wheel injuries and heel pad defects fulfilling the inclusion criteria were graded and treated as per Zhu and Li classification with reverse sural artery flap and followed up for flap survival and ankle range of motion. Results: A total of 15 patients with motorbike spoke-wheel injuries and heel pad defects were included in our study. Male patients were 12(80%) and female were 3 (20%). Mean age of our patients was 24.4±5.1 years(range 18 to 36 years). Right foot was involved in 13 (86.6%) cases whereas 2 (13.3%) patients had left foot injury. Mean duration from injury to flap coverage was 16 ±4 days(range 5 to 20 days).In majority(86.6%,n=13) of our patients reverse sural artery flap survived while in 2(13.3%) patients partial necrosis was noted. Normal ankle range of motion was regained in 14(93.3%) patients while 1(6.6%) had restricted dorsiflexion. Conclusion: Reverse sural artery flap proved to be a reliable surgical technique for coverage of heel pad wound defects due to motorbike spoke-wheel injuries. We therefore, recommend this flap as a technique of choice to treat heel pad defects due to motorbike spoke-wheel injuries.