Medial Sural Perforator “Nerve through Flap”: Anatomical Study and Clinical Application

Background: Nerve recovery after a complex trauma is affected by many factors and poorly vascularized bed often the cause of failure perineural scar. Many techniques have been devised to avoid this problem possibility transfer nerve with surrounding viable sliding tissue could help in purpose; Methods: We performed an anatomic study on 8 injected specimens investigate raise medial sural artery perforator (MSAP) flap including within its sheath; Results: In specimens, visible direct vascularization was present 57% legs (8 out 14). 43% vascular network fascia layer. There were no anomalies. one patient MSAP raised proximal tibial peroneal components deep sheath. The component anastomized independently common digital 4th 5th fingers collateral for ulnar aspect 5th. After 9 months, showed improving function both clinically electromyographically without any due adherence; Conclusions: Given still debated advantage graft versus non-vascularized one, be useful those cases composite wounds lesions acting as “nerve through flap”, order reduce adherence gliding tissue.