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Various Applications of the Medial Plantar Flap to Cover the Defects of the Plantar Foot, Posterior Heel, and Ankle

2003; Lippincott Williams & Wilkins; Volume: 50; Issue: 5 Linguagem: Inglês

10.1097/01.sap.0000044141.35292.a7

1536-3708

Cengiz Açıkel, Bahatti̇n Çeli̇köz, Fuat Yüksel, Özge Ergün,

Tendon Structure and Treatment

In Brief The medial plantar fasciocutaneous flap provides structurally similar tissue to plantar foot, posterior heel, and ankle defects with its thick glabrous plantar skin, shock-absorbing fibrofatty subcutaneous tissue, and plantar fascia. During the past 4 years, 24 patients (20 men, 4 women) with skin and soft-tissue defects over the plantar foot, posterior heel, or ankle were treated. They ranged in age from 20 to 42 years (mean, 24 y). The medial plantar flap was transposed to the defects in four different ways: proximally pedicled sensorial island flaps (N = 18), reverse-flow island flaps (N = 2), free flaps (N = 2), and cross-foot flaps (N = 2). Flap size varied from a width of 2 to 5.5 cm and a length of 5 to 7.5 cm. The follow-up period ranged from 2 to 18 months (mean, 9 mo). Partial flap loss was observed in one free flap and one reverse-flow island flap. Partial skin graft lost in the donor site required regrafting in one patient. Durable, sensate coverage of the defects was achieved in all patients. Twenty-four defects of the plantar foot, posterior heel, or ankle were reconstructed with medial plantar fasciocutaneous flaps transferred as proximally based sensory islands, reverse-flow islands, free flaps, or cross-foot flaps. All flaps survived with the exception of partial loss of one free flap and one reverse-flow island flaps.