{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:50:14Z","timestamp":1786978214218,"version":"build-2736575974"},"reference-count":99,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T00:00:00Z","timestamp":1373932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:p>Soft tissue coverage in the distal lower extremity remains a significant challenge. While free flaps are often utilized for larger defects, local perforator\u2010based propeller flaps may be ideal for smaller wounds requiring coverage. Propeller flaps can provide excellent form and function for both traumatic and atraumatic defects with minimal donor site morbidity but can have concerning rates of flap loss. We reviewed the literature, identifying 21 studies presenting 310 propeller flaps for distal lower extremity reconstruction. Total flap necrosis was noted in 5.5% of flaps, with partial necrosis in 11.6%. While these flaps do enable transfer of local, healthy tissue to the defect site without the need for a microsurgical anastomosis, this rate of flap loss is concerning and appropriate patient selection is crucial. This review provides a brief history and overview of the clinical application and research into distal lower extremity perforator propeller flaps to place this technique into a clinical context. \u00a9 2013 Wiley Periodicals, Inc. Microsurgery 33:578\u2013586, 2013.<\/jats:p>","DOI":"10.1002\/micr.22134","type":"journal-article","created":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T07:44:41Z","timestamp":1373960681000},"page":"578-586","source":"Crossref","is-referenced-by-count":81,"title":["A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high?"],"prefix":"10.1002","volume":"33","author":[{"given":"Jonas A.","family":"Nelson","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Brazio","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Kovach","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gedge D.","family":"Rosson","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Johns Hopkins Hospital Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel N.","family":"Rad","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Johns Hopkins Hospital Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181c82ed1"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0007-1226(81)80097-5"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20557"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(84)90049-3"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anplas.2010.11.004"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198804000-00012"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000222582.84385.54"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181bcf189"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2008.05.020"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000133171.65075.81"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2008.11.086"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181ccdc08"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10195-011-0136-0"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31803c9b66"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198608000-00008"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.12.053"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199008000-00019"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000152421.62240.B5"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199809010-00001"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-39828"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2005.10.020"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1223847"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200112000-00019"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181a72f8c"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000206957.02510.40"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198509000-00003"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(86)90043-3"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1098-2752(1996)17:9<503::AID-MICR5>3.0.CO;2-D"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000282076.31445.b4"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(93)90220-6"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199710000-00016"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181774386"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1315786"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000250599.84033.1f"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31817433f8"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198206000-00020"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(91)90179-N"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2005.07.007"},{"key":"e_1_2_6_40_1","volume-title":"Our Experience of the Propeller Descending Genicular Artery Propeller Flap","author":"Moscatiello FMJ"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000210512.81988.2b"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31803df4e9"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000196561.92828.d7"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1006\/jsre.1997.5228"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000135877.48241.5A"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-200112000-00011"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.10150"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20281"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.10092"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20886"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20918"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20981"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22039"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199210000-00014"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-922435"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000237573.63778.bb"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181a13dd6"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.03.029"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1268855"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(97)00175-X"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198908000-00005"},{"key":"e_1_2_6_62_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20888"},{"key":"e_1_2_6_63_1","article-title":"Lower extremity free flap outcomes using an anastomotic venous coupler device","author":"Medina ND","journal-title":"Ann Plast Surg"},{"key":"e_1_2_6_64_1","article-title":"Early postoperative outcomes associated with the anterolateral thigh flap in Gustilo IIIB fractures of the lower extremity","author":"Christy MR","journal-title":"Ann Plast Surg"},{"key":"e_1_2_6_65_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20696"},{"key":"e_1_2_6_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0007-1226(97)90329-5"},{"key":"e_1_2_6_67_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-941717"},{"key":"e_1_2_6_68_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199004000-00004"},{"key":"e_1_2_6_69_1","article-title":"Subfascial directionality of perforators of the distal lower extremity: An anatomic study regarding selection of perforators for 180\u2010degree propeller flaps","author":"Jakubietz RG","journal-title":"Ann Plast Surg"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2008.08.032"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2011.03.015"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.09.014"},{"key":"e_1_2_6_73_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318200a99e"},{"key":"e_1_2_6_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.10.077"},{"key":"e_1_2_6_75_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318189383d"},{"key":"e_1_2_6_76_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181f02ee3"},{"key":"e_1_2_6_77_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/303247"},{"key":"e_1_2_6_78_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181a14775"},{"key":"e_1_2_6_79_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1006703"},{"key":"e_1_2_6_80_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-005-0059-7"},{"key":"e_1_2_6_81_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199211000-00008"},{"key":"e_1_2_6_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(93)90149-6"},{"key":"e_1_2_6_83_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20981"},{"key":"e_1_2_6_84_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199006000-00012"},{"key":"e_1_2_6_85_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-922432"},{"key":"e_1_2_6_86_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20069"},{"key":"e_1_2_6_87_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000258969.13723.68"},{"key":"e_1_2_6_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.05.004"},{"key":"e_1_2_6_89_1","unstructured":"GrayH.The anterior tibial artery. In:Anatomy of the Human Body Warren H. Lewis Ed.Philadelphia:Lea and Febiger;1918. p Available at:www.bartleby.com\/107\/."},{"key":"e_1_2_6_90_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.1090800307"},{"key":"e_1_2_6_91_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3180cab77f"},{"key":"e_1_2_6_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(81)90061-8"},{"key":"e_1_2_6_93_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000086771.77788.6C"},{"key":"e_1_2_6_94_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198703000-00014"},{"key":"e_1_2_6_95_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(88)90171-3"},{"key":"e_1_2_6_96_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(87)90115-9"},{"key":"e_1_2_6_97_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(86)90042-1"},{"key":"e_1_2_6_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2008.06.013"},{"key":"e_1_2_6_99_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3181bee36e"},{"key":"e_1_2_6_100_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000239841.47088.a5"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmicr.22134","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmicr.22134","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.22134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T16:25:47Z","timestamp":1696350347000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.22134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,16]]},"references-count":99,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1002\/micr.22134"],"URL":"https:\/\/doi.org\/10.1002\/micr.22134","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,16]]}}}