Subscribe to RSS
Download PDF
DOI: 10.1055/s-0041-1735424
“Like For Like” Reconstruction of Heel Pad with Medial Plantar Artery Flap—Functional and Aesthetic Outcomes in A Series of 19 Cases
Funding/Grants Nil.
Abstract
Heel pad loss can cause serious problems in weight-bearing and locomotion. The medial plantar artery (MPA) flap is a suitable “like for like” replacement. Nineteen patients whose heels were reconstructed with MPA flap between July 2015 and February 2020 were studied. All patients were assessed based on flap survival, functionality, and patient satisfaction. Loss of heel pad was due to diabetic ulcer (11), trauma (6), tumor (1), and unstable scar (1). The largest flap measured 9 × 7 cm. Sixteen flaps were done as fasciocutaneous flaps and three in combination with abductor hallucis muscle (AbdH). All the flaps survived. The average functional scores at 6, 12, 18, and 24 months were 86.86, 89.62, 89.38 and 97.33 based on AOSAS-AH score. Average patients' satisfaction was 8.7/10. To conclude, the MPA system is a versatile vascular axis providing “like for like” tissue for heel pad reconstruction which is reliable and durable.
Publication History
Article published online:
17 September 2021
© 2021. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Harrison DH, Morgan BD. The instep island flap to resurface plantar defects. Br J Plast Surg 1981; 34 (03) 315-318
- 2 Schwarz RJ, Negrini JF. Medial plantar artery island flap for heel reconstruction. Ann Plast Surg 2006; 57 (06) 658-661
- 3 Gu JX, Huan AS, Zhang NC. et al Reconstruction of heel soft tissue defects using medial plantar artery island pedicle flap: clinical experience and outcomes analysis. J Foot Ankle Surg 2017; 56 (02) 226-229
- 4 Khai Luen K, Wan Sulaiman WA. Functional outcomes after heel pad reconstruction: a review of 7 cases. J Foot Ankle Surg 2017; 56 (05) 1114-1120
- 5 Dolan RT, Butler JS, Murphy SM, Cronin KJ. Health-related quality of life, surgical and aesthetic outcomes following microvascular free flap reconstructions: an 8-year institutional review. Ann R Coll Surg Engl 2012; 94 (01) 43-51
- 6 Rodriguez-Vegas M. Medialis pedis flap in the reconstruction of palmar skin defects of the digits: clarifying the anatomy of the medial plantar artery. Ann Plast Surg 2014; 72 (05) 542-552
- 7 Low OW, Sebastin SJ, Cheah AEJ. A review of pedicled perforator flaps for reconstruction of the soft tissue defects of the leg and foot. Indian J Plast Surg 2019; 52 (01) 26-36
- 8 Macchi V, Tiengo C, Porzionato A. et al Correlation between the course of the medial plantar artery and the morphology of the abductor hallucis muscle. Clin Anat 2005; 18 (08) 580-588
- 9 Scaglioni MF, Rittirsch D, Giovanoli P. Reconstruction of the heel, middle foot sole, and plantar forefoot with the medial plantar artery perforator flap: clinical experience with 28 cases. Plast Reconstr Surg 2018; 141 (01) 200-208
- 10 Guillier D, Campisi C, Krähenbühl SM, Raffoul W, di Summa PG. Bipedicled distally based medial plantar artery perforator flap for forefoot reconstruction: a case report. Microsurgery 2020; 40 (04) 497-500
- 11 Siddiqi MA, Hafeez K, Cheema TA, Rashid HU. The medial plantar artery flap: a series of cases over 14 years. J Foot Ankle Surg 2012; 51 (06) 790-794
- 12 Yang D, Yang JF, Morris SF, Tang M, Nie C. Medial plantar artery perforator flap for soft-tissue reconstruction of the heel. Ann Plast Surg 2011; 67 (03) 294-298
- 13 Wan DC, Gabbay J, Levi B, Boyd JB, Granzow JW. Quality of innervation in sensate medial plantar flaps for heel reconstruction. Plast Reconstr Surg 2011; 127 (02) 723-730
- 14 Periyasamy R, Manivannan M, Narayanamurthy VBR. Changes in two point discrimination and the law of mobility in diabetes mellitus patients. J Brachial Plex Peripher Nerve Inj 2008; 3: 3
- 15 Rinkel WD, Aziz MH, Van Deelen MJ. et al Normative data for cutaneous threshold and spatial discrimination in the feet. Muscle Nerve 2017; 56 (03) 399-407
- 16 Chen Y-C, Scaglioni MF. The lateral plantar artery as recipient vessel for microsurgical lateral plantar forefoot reconstruction. Case Report International Microsurgery Journal 2017; 1 (02) 2