Peroneal artery perforator flap for repairing the soft tissue defects on the foot and lower 1/3 of the lateral lower leg
Why this work is in the frame
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Bibliographic record
Abstract
• This is a relatively large case series (50 cases) of PAP flaps for distal lower leg and foot reconstruction, with proper functional evaluation • The study includes 25 PAPF cases and 25 pedicled PAP flaps cases, achieved dual-modality reconstruction, enabling comparison of the characteristics and clinical outcomes of each approach. • The incorporation of the lateral sural cutaneous nerve was synergistically combined with aesthetic refinement, achieving both functional sensory restoration and optimal contour outcomes. • Comprehensive and refined introduction to the surgical process. The purpose of this study is to evaluate the clinical outcomes of 50 PAP flaps cases we have treated and to compare the differences between PAPF and pedicled PAP flaps. The soft tissue defects on the foot and lower 1/3 of the lateral lower leg have been repaired using some procedures. However, improvements in function and aesthetics have not been well addressed. We have achieved some satisfactory curative effects in the application of the peroneal artery perforator (PAP) flap and conducted an analysis. This study presented our experience with PAP flaps to repair the foot and lower 1/3 of the lateral lower leg. From January 2017 to February 2022, 50 patients with these defects received total treatment using the PAP flaps. All flaps were carefully designed, including 25 patients with free anastomotic vascular flap and others with perforator-based propeller flap or pedicled flap. We followed up all patients regularly and completed standardized assessments of outcomes based on functional and aesthetic scores. 1 free flap showed arterial crisis and 3 perforator-based propeller flap showed distal mild necrosis. The remaining flaps survived successfully. At the last follow-up, the donor sites demonstrated median modified Vancouver Scar Scale (mVSS) scores of 2 (ranged, 0-5). Evaluation of 28 foot and ankle injury cases using the American Orthopaedic Foot & Ankle Society (AOFAS) system revealed: excellent outcomes in 22 cases (78.6%) and good outcomes in 6 cases (21.4%). The Semmes-Weinstein monofilament (SWM) test demonstrated normal protective sensation in 45 cases (90%) and diminished light touch perception in 5 cases (10%). Cold Intolerance Symptom Severity (CISS) scores were graded as mild in 43 cases (86%) and moderate in 7 cases (14%). Natural shapes and walking functions were achieved. The PAP flap has relatively stable and selectable perforators, is close to the recipient sites and can carry the lateral sural cutaneous nerve to reconstruct the sensation in lower limbs. It provides cosmetic coverage, allowing faster wound healing and reduced tissue adhesion. The PAP flap is one of the most ideal methods to repair the tissue defect on the foot and lower 1/3 of the lateral lower leg.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it