Fig. 4

Photographs illustrating the propeller flap operative technique with double pivoting using a posterior tibial artery perforator in a 58-year-old man. A, B, C Post-debridement of the necrosis of the distal third of the posterior leg. D Defect with standard marking and perforator location. E, F, G Insetting the flap into the leg defect using the pedicled propeller flap technique. H, I Partial flap necrosis at 3 weeks postoperatively. J, K Split-thickness skin grafting performed after debridement. L A good result at 14 months postoperatively