Work

Heel reconstruction using a combination of free sensate medial plantar flap and skin graft: A case series

Year: 2025

Type: article

Abstract: 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.

Source: JPRAS Open

DOI: 10.1016/j.jpra.2025.03.007

Authors: Omid Liaghat, Zohre Shabbooie

Institutions: Iran University of Medical Sciences, Shiraz University of Medical Sciences

Language: English

Topic: Reconstructive Surgery and Microvascular Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,920