Heel reconstruction using a combination of free sensate medial plantar flap and skin graft: A case series
Managing soft tissue defects in the heel presents a significant challenge for surgeons due to the heel's crucial role in weight-bearing. A free instep flap with end-to-side nerve coaptation offers an effective solution for reconstructing large heel defects. Four patients were referred to our ho...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | JPRAS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352587825000518 |
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| Summary: | Managing soft tissue defects in the heel presents a significant challenge for surgeons due to the heel's crucial role in weight-bearing. A free instep flap with end-to-side nerve coaptation offers an effective solution for reconstructing large heel defects. Four patients were referred to our hospital with soft tissue lesions in the weight-bearing heel and instep area. Their heels were reconstructed using a free instep flap harvested from the opposite foot. In three cases, an end-to-side arterial anastomosis was performed. In the fourth case, due to a midfoot amputation, an end-to-end arterial anastomosis was performed more distally to preserve collateral branches. In all cases, the vein was anastomosed end-to-end to the posterior tibial vein. The epineurium of the medial plantar nerve was opened, and an end-to-side nerve repair was performed. Our patients demonstrated satisfactory sensation, and none experienced flap shearing or ulceration. The flap thickness and shape were ideal, closely resembling the contralateral normal side. |
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| ISSN: | 2352-5878 |