Medial plantar artery flap: a versatile workhorse flap for foot reconstruction, our experience

Authors

  • Sankit B. Shah Department of Burns, Plastic and Reconstructive Surgery, Shardaben General Hospital, NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Ankit Shah Department of Burns, Plastic and Reconstructive Surgery, Shardaben General Hospital, NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Janvi Tomar Department of Burns, Plastic and Reconstructive Surgery, Shardaben General Hospital, NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Dhruv V. Patel Department of Burns, Plastic and Reconstructive Surgery, Shardaben General Hospital, NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Purandar Ribadia Department of Burns, Plastic and Reconstructive Surgery, Shardaben General Hospital, NHL Municipal Medical College, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232170

Keywords:

Medial plantar artery flap, Sole defect, Foot reconstruction, Foot reconstruction workhorse flaps, Pedicled flaps

Abstract

Soft tissue defect in the foot is commonly seen as it is more prone to trophic ulcers since it is the main weight bearing area of the body. Reconstruction of the weight bearing area of the foot requires the provision of a stable, supple, durable and preferably sensate skin coverage. Following Sir Gilli’s principle of replacing like with like, medial plantar artery flap provides an anatomically similar, glabrous skin for coverage on the plantar surface. In the present study, we share our clinical experience with the use of medial plantar artery flap for coverage of soft tissue defect over sole of foot. At our institution, a total of 10 patients presented with soft tissue defect of the sole, underwent medial plantar artery flap coverage. All the 10 patients were diagnosed cases of type 2 DM. patient outcome was assessed according to patients’ age distribution, duration of surgery, hospital stay, and post operative complications. Out of all the 10 patients, 5 were male and 5 were female. All the flaps healed uneventfully without major complications like partial flap necrosis. Donor site was covered with split thickness skin graft. There was suture site dehience in 2 cases which healed with secondary healing. Medial plantar artery flap has been described as an optimal reconstructive option for this type of soft tissue defect.

 

References

Barczak CA, Barnett RI, Childs EJ. Fourth national pressure ulcer prevalence survey. Adv Wound Care. 1997;10(4):18-26.

Boffeli TJ, Collier RC. Near total calcanectomy with rotational flap closure of large decubitus heel ulcerations complicated by calcaneal osteomyelitis. J foot ankle Surg. 2013;52:107-12.

Evans KK, Attinger CE, Attar A. The importance of limb preservation in the diabetic population. J diabetes Complications. 2011;25(4):227-31.

Faglia E, Clerici G, Caminiti M. Influence of osteomyelitis location in the foot of diabetic patients with transtibial amputation. Foot Ankle Int. 2013;34(2):222-7.

Wann CD, Gabbay J, Levi B. Quality of innervation in sensate medial plantar flaps for heel reconstruction. Plast Reconstr Surg. 2011;127(2):723-30.

Mourougayan V. Medial plantar artery (instep flap) flap. Ann Plast Surg. 2006;56(2):160-3.

Okada T, Tsukuda S. Coverage of heel defects by musculocutaneous and fasciocutaneous flap based on medial plantar neurovascular bundle. Eur J Plast Surg. 1986;9:117-21.

Bibbo C. Plantar heel reconstruction with a sensate plantar medial artery musculocutaneous pedicled island flap after wide excision of melanoma. J Foot Ankle Surg, 2012;51:504-8.

Schwarz RJ, Negrini JF. Medial plantar artery island flap for heel reconstruction. Ann Plast Surg. 2006;57(6):658-61.

Benito-Ruiz J, Yoon T, Guisantes-pintos E. Reconstruction of soft-tissue defects of the heel with local fasciocutaneous flaps. Ann Plast Surg. 2004;52(4):380-4.

Siddiqi MA, Hafeez K, Cheema TA. The medial plantar artery flap: a series of cases over 14 years. J Foot Ankle Surg. 2012;51:790-4.

Masquelet AC, Romana MC. The medialis pedis flap: a new fasciocutaneous flap. Plast Reconstr Surg. 1990;85:765-72.

Mahmoud WH. Foot and ankle reconstruction using the distally based sural artery flap versus the medial plantar flap: a comparative study. J Foot Ankle Surg. 2017;56:514-8.

Rashid M, Hussain SS, Aslam R. A comparison of two fasciocutaneous flaps in the reconstruction of defects of the weight bearing heel. J Coll Physicians Surg Pak. 2003;13:216-8.

Tanaka K, Igari K, Kishino M. The possibility of free tissue transfer as a nutrient flap for critical ischemic foot: a case report. Microsurgery. 2017;37(6):694-8.

Javed MU, Josty IC. Salvage of a complex first metatarso-phalangeal joint injury and synchronous reconstruction of medial collateral ligament and soft tissue with a distally based medial plantar artery flap. J Plast Reconstr Aesthet Surg. 2016;69:e61.

Wu H, Sheng JG, Zhang CQ. Free medial plantar flap connection with a posterior tibial artery flap in reconstruction of fore-mid foot skin defect. Plast Reconstr Surg Glob Open. 2016;4:e1091.

Downloads

Published

2023-07-17

How to Cite

Shah, S. B., Shah, A., Tomar, J., Patel, D. V., & Ribadia, P. (2023). Medial plantar artery flap: a versatile workhorse flap for foot reconstruction, our experience. International Journal of Research in Medical Sciences, 11(8), 3002–3008. https://doi.org/10.18203/2320-6012.ijrms20232170

Issue

Section

Case Series