Purpose Statement: Soft tissue coverage of traumatic wounds to the distal lower extremity remains a challenge in plastic surgery. Despite continued advances in microvascular technique and training free flap coverage can still present the patient with significant morbidity. Locoregional flaps can be used to cover some traumatic defects, but random flaps often do not provide enough tissue coverage to repair larger, more complex wounds. The posterior tibial artery perforator flap has been described by several anatomical studies, but few large case series have reported on it's efficacy in repairing traumatically acquired soft tissue defects.

Materials and Methods: All of the posterior tibial perforator flaps over a 1 year period were reviewed. The mechanism of injury, size and location of the wound, duration of procedure, length of hospital stay and complications resulting from surgery were all investigated and recorded. All patients were followed up in the outpatient clinic at least until complete healing of both the traumatic wound and any resulting donor site wound.

Results: A total of XXX flaps were performed on XXX patients with XXX resulting complications. Patients experienced an operation and hospital stay that was on the average shorter than that typically experienced by patients undergoing free flap reconstruction.

Conclusion: The posterior tibial artery perforator flap is a viable alternative to free flap reconstruction in select patients with distal lower extremity soft tissue defects after trauma. Our complication rate has been very low with the added benefits of shorter operative times and hospital stays.