Figure 2.

A – CR. 1, flap elevation. 72 years lady was suffering from ulcer on dorso medial aspect of midfoot as a result of long standing diabetes mellitus leading to peripheral neuropathy. Sural artery flap was utilized; its elevation is seen from the proximal aspect of the posterior calf area, modified by the inclusion of midline gastrocnemius muscle cuff around the sural pedicle. B – CR. 1, Post op. Adequate coverage seen in the immediate post operative period. The pedicle was kept wide and not passed through subcutaneous tunnel. It required split thickness skin grafting for coverage. The flap developed mild distal congestion which resolved spontaneously with foot elevation without any problems.