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Here, we explored the feasibility and clinical outcomes of a modified anterior tibial artery perforator\u2010pedicled propeller flap for the repair of soft\u2010tissue defects of the ankle and heel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Between January 2013 and December 2015, 12 patients with soft\u2010tissue defects of the ankle and\/or heel underwent reconstructive surgery that included our flap technique. The flaps measured 20\u2009\u00d7\u20098\u00a0cm to 7\u2009\u00d7\u20094\u00a0cm. A hand\u2010held Doppler was used to identify a proper constant perforator in the distal ankle. In each case, the base of the flap was well preserved. The flap was transposed (180\u00b0 rotation) to reach and cover the defect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average follow\u2010up time was 13\u00a0months (10\u201328\u00a0months). We observed good texture matches and contour in all of the flaps. All patients could walk and wear normal footwear. All but one flap survived completely without complications. Partial loss was observed in one patient, and the necrotic region was healed with secondary intention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our modified anterior tibial artery free\u2010style perforator\u2010pedicled propeller flap provides a novel option for functional ankle and heel reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05452-y","type":"journal-article","created":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T19:02:47Z","timestamp":1583175767000},"page":"2237-2242","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Modified Anterior Tibial Artery Perforator\u2010Pedicled Propeller Flap for Soft\u2010Tissue Coverage of the Ankle and 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