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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Bibliographic Details
Main Authors: Omid Liaghat, Zohre Shabbooie
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JPRAS Open
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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.
ISSN:2352-5878