OBJECTIVE: To provide a series of surgical approaches for treatment of talus neck fracture, ischemic necrosis of talus body, and other bone lesions in ankle and foot. METHODS: The major blood supply to cuboid bone, medial cuneiform bone and navicular bone was observed in 30 adult cadavers, by infiltration of red emulsion via major arteries of the lower limbs. Based on these anatomical investigations, 3 types of vascularized tarsal bone grafting were designed for repair of bone lesions in the area of ankle and foot, and applied in 49 clinical cases, ranging from 10 to 58 years in age, and 43 cases of which were followed up for 4 years and 3 months in average. RESULTS: Primary healing was achieved in 40 cases, and secondary healing achieved after further surgical intervention in other 3 cases. The function of all ankle joints recovered satisfactorily. CONCLUSION: The designed three types of vascularized tarsal bone flaps are easy and reliable for dissection because of their superficial pedicles, and they are available for different clinical cases with various bone lesions in ankle and foot.