Sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regime

Background: For reconstruction of the foot, a medial plantar flap is used to provide a like-for-like replacement. The problem at present seems to be that there are no objective criteria to guide the rehabilitation regimes of these patients. The arbitrary rule that the patient may begin weight-bearin...

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Main Authors: Dipankar Mukherjee, Monali Patole Mukherjee, Santu Kumar Chejara, Akshay Kapoor, Debarati Chattopadhyay
Format: Article
Language:English
Published: Manipal College of Medical Sciences, Pokhara 2025-06-01
Series:Asian Journal of Medical Sciences
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Online Access:https://ajmsjournal.info/index.php/AJMS/article/view/4503
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author Dipankar Mukherjee
Monali Patole Mukherjee
Santu Kumar Chejara
Akshay Kapoor
Debarati Chattopadhyay
author_facet Dipankar Mukherjee
Monali Patole Mukherjee
Santu Kumar Chejara
Akshay Kapoor
Debarati Chattopadhyay
author_sort Dipankar Mukherjee
collection DOAJ
description Background: For reconstruction of the foot, a medial plantar flap is used to provide a like-for-like replacement. The problem at present seems to be that there are no objective criteria to guide the rehabilitation regimes of these patients. The arbitrary rule that the patient may begin weight-bearing after 4 weeks of surgery may not be applicable to all patients as the etiology of the defect and time for recovery may differ. Aims and Objectives: The study was conducted with the primary objective of ascertaining the time needed for sensory recovery in the pedicled medial plantar flap. The secondary objective was to identify guidelines regarding weight-bearing on the flap during the recovery period. Materials and Methods: A prospective observational study was done, with the primary objective of recording the time in which sensory recovery occurs in sensate pedicled flaps. In 4 years, 14 patients who underwent medial plantar flap reconstruction were assessed. The sensory outcome of medial plantar flaps was assessed using 2-point discrimination (2PD) of the flap area compared with the heel of the normal leg. Results: Tactile sensation was found to recover within one month, but 100% recovery of pain and temperature sensation took about 6 months. A Mann–Whitney test to compare the 2PD scores of the flap to the normal heel showed them to be comparable at 6 months post-operative. Conclusion: Complete sensory recovery even in a sensate flap can take about 6 months and the patient needs to be counseled regarding using assisted weight-bearing and daily foot examination until that period is complete.
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spelling doaj-art-c4a58acddf1348bfa068dfc7ad7d28ed2025-08-20T03:55:22ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-06-016136141https://doi.org/10.71152/ajms.v16i6.4503Sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regimeDipankar Mukherjee0https://orcid.org/0000-0003-3068-459XMonali Patole Mukherjee 1https://orcid.org/0000-0002-2636-6524Santu Kumar Chejara 2https://orcid.org/0000-0003-0794-2941Akshay Kapoor3https://orcid.org/0000-0003-4223-9039Debarati Chattopadhyay 4https://orcid.org/0000-0002-0167-7561Associate Professor, Department of Plastic Surgery, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India Assistant Professor, Department of Paediatric Surgery, Medical College, Medical College, Kolkata, West Bengal, India Assistant Professor, Department of Surgical Oncology, Medical College, Kolkata, West Bengal, India Associate Professor, Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India Professor, Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India Background: For reconstruction of the foot, a medial plantar flap is used to provide a like-for-like replacement. The problem at present seems to be that there are no objective criteria to guide the rehabilitation regimes of these patients. The arbitrary rule that the patient may begin weight-bearing after 4 weeks of surgery may not be applicable to all patients as the etiology of the defect and time for recovery may differ. Aims and Objectives: The study was conducted with the primary objective of ascertaining the time needed for sensory recovery in the pedicled medial plantar flap. The secondary objective was to identify guidelines regarding weight-bearing on the flap during the recovery period. Materials and Methods: A prospective observational study was done, with the primary objective of recording the time in which sensory recovery occurs in sensate pedicled flaps. In 4 years, 14 patients who underwent medial plantar flap reconstruction were assessed. The sensory outcome of medial plantar flaps was assessed using 2-point discrimination (2PD) of the flap area compared with the heel of the normal leg. Results: Tactile sensation was found to recover within one month, but 100% recovery of pain and temperature sensation took about 6 months. A Mann–Whitney test to compare the 2PD scores of the flap to the normal heel showed them to be comparable at 6 months post-operative. Conclusion: Complete sensory recovery even in a sensate flap can take about 6 months and the patient needs to be counseled regarding using assisted weight-bearing and daily foot examination until that period is complete.https://ajmsjournal.info/index.php/AJMS/article/view/4503sensory recovery; medial plantar flap; rehabilitation
spellingShingle Dipankar Mukherjee
Monali Patole Mukherjee
Santu Kumar Chejara
Akshay Kapoor
Debarati Chattopadhyay
Sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regime
Asian Journal of Medical Sciences
sensory recovery; medial plantar flap; rehabilitation
title Sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regime
title_full Sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regime
title_fullStr Sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regime
title_full_unstemmed Sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regime
title_short Sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regime
title_sort sensory recovery in medial plantar flaps for posterior heel defects as a guide to rehabilitation regime
topic sensory recovery; medial plantar flap; rehabilitation
url https://ajmsjournal.info/index.php/AJMS/article/view/4503
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