Propeller flaps for lower-limb trauma
The propeller flap has become a versatile and important component in our reconstructive algorithm following complex lower limb trauma. First described by Hyakusoku in 1991, it has since been adapted and modified by Hallock and Teo. This article outlines our experience specifically with perforator pedicled propeller flaps (as per the Tokyo consensus) for traumatic defects of the leg. In this procedure, the reconstructive surgeon skeletonises a single perforator and rotates the skin island on its axis between 90o and 180o to close the defect. The minor blade of the propeller may be designed to close the donor defect completely for the 180o version. The propeller flap has the advantages of local flaps (reliability, contour, texture, ‘like-with-like’) with additional versatility of design and donor site management, and requires minimal expertise and operative time.