Donor site morbidity of the medial plantar artery flap studied with gait and pressure analysis

Paget, James; Izadi, David; Haj-Basheer, Mohammed; Barnett, Sue; Winson, Ian; Khan, Umraz

doi:10.1016/j.fas.2014.09.009

Cited by 15 publications

(8 citation statements)

References 21 publications

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“…Impulse value refers to the product of touchdown time and pressure in each stress area of the foot in each cycle. The increase of impulse is more suggestive of fatigue damage and subsequent foot deformities, such as valgus, than the increase of peak stress [17]. Therefore, this clinical experiment evaluates the regularity of the stress distribution of the plantar with time during a walking cycle from a dynamic perspective.…”

Section: Discussionmentioning

confidence: 99%

Repair of thumb defect by using the toenail flap: biomechanical analysis of donor foot—a retrospective cohort study

Liu

Liu²,

et al. 2019

J Orthop Surg Res

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Background The thumb accounts for 50% of the total hand function. This study reports the functional outcomes and complications of people with traumatic thumb amputations who underwent toe-to-thumb reconstruction. Methods From January 2013 to January 2018, 29 patients with second-degree thumb defect underwent thumb reconstruction with distal phalangeal braided toenail flap. The footscan foot pressure gait analysis system was used to measure the index changes of the same foot before and after 1, 3 and 6 months. The contact area, peak pressure, impulse value, contact time of each gait phase, centre of gravity coordinate and foot balance were analysed statistically. Results Twenty-nine cases of thumb reconstruction recovered well. After following up for 6–15 months, the appearance of the reconstructed thumb was close to normal, and the sensation was restored to S3 + . The two-point discrimination was 6–8 mm, and the function of the thumb was good. The function of the donor foot was well restored, and no skin ulceration, pain and claudication were noted during walking. Compared with that before the operation, the biomechanical indices of the donor foot were basically restored to normal 6 months after the operation. Only the stress and impulse values of the third metatarsal head were significantly increased, forming a stress concentration area centred on the third metatarsal head. Conclusions This study confirmed that the toenail flap with distal phalangeal bone restored the second-degree thumb defect without destroying the main functional structure of the sole. The biomechanical indices of the donor foot were basically restored to normal 6 months after the operation. Only the stress concentration area centred on the third metatarsal head, and the pain on the forefoot was induced after the operation. Discomfort, callus formation, metatarsal fasciitis, etc., can lead to fatigue fracture of the third metatarsal bone in severe cases, which requires further follow-up and observation. Trial registration Clinicaltrials.gov , NCT03879941; registered on 10 March 2019, retrospectively.

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Section: Discussionmentioning

confidence: 99%

Repair of thumb defect by using the toenail flap: biomechanical analysis of donor foot—a retrospective cohort study

Liu

Liu²,

et al. 2019

J Orthop Surg Res

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“…Although use of the medial plantar flap has some effect on intrinsic muscle function in the foot, this does not seem to affect ambulation. 3 Because the area of the donor site provides a viable well vascularised wound bed it can be closed using a split skin graft. The medial plantar artery is derived from the posterior tibial artery and runs along the medial side of the foot, supplying nearby muscles and the plantar aspect of the big toe.…”

Section: Long Answermentioning

confidence: 99%

Management of soft tissue defects of the foot

Trevatt

Igwe

Khan

2015

BMJ

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“…Due to the durability, mobility, and sensory functions of fingers, the candidate donors are required to have similar properties, texture, thickness, and sensitivity (1,2). Meanwhile, less significant morbidity of the donor site and complication rate should be considered in choosing surgical methods (3)(4)(5). It is challenging for surgeons to repair wounds, restore appearance, and reconstruct the functions of fingers.…”

Section: Introductionmentioning

confidence: 99%

“…(4) The color and texture of the medial plantar flap is similar to that of real human fingers. More durability can be achieved (5). The recovery of protective sensation in the finger is good with or without neurorrhaphy since the medial plantar flap is thin (15).…”

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confidence: 99%

Medial plantar artery perforator (MPAP) flap is an ideal option for reconstruction of complex soft tissue defect in the finger: Clinical experience from 11 cases

Wang

Chen

et al. 2022

Front. Surg.

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IntroductionSoft tissue defects of fingers are common in reconstructive plastic surgery, and reconstruction of the defects remains challenging for plastic surgeons. In our study, we reported our experience in finger reconstruction with a medial plantar artery perforator (MPAP) flap, especially using a lobulated MPAP flap for the complex multifinger soft defect.Patients and methodsFrom the period April 2012 to October 2018, 11 patients (9 males and 2 females) with an average age of 44 years old (ranging from 11 to 58) received finger reconstruction with a free MPAP flap. In total, 11 flaps (8 single-lobulated flaps and 3 two-lobulated flaps) were raised from the ipsilateral or contralateral instep area. Trauma and scar contracture caused hand soft tissue loss in all cases.ResultsThe sizes of the flaps ranged from 2×3 to 5×7.5 cm2. All flaps survived intact with no complications. One donor site was closed primarily, and other donor sites were covered with a full-thickness skin graft. The mean follow-up time was 6 months (ranging from 3 to 8 months). During the follow-up period, the patients were satisfied with their appearance without any traces of flap plastic surgery.ConclusionThe MPAP flap is a reliable and acceptable option for the reconstruction of complex soft tissue defects in the finger. Depending on the two branches of the medial plantar artery, the use of the lobulated MPAP flap holds promise in the treatment of multifinger soft tissue defects.

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Donor site morbidity of the medial plantar artery flap studied with gait and pressure analysis

Cited by 15 publications

References 21 publications

Repair of thumb defect by using the toenail flap: biomechanical analysis of donor foot—a retrospective cohort study

Repair of thumb defect by using the toenail flap: biomechanical analysis of donor foot—a retrospective cohort study

Management of soft tissue defects of the foot

Medial plantar artery perforator (MPAP) flap is an ideal option for reconstruction of complex soft tissue defect in the finger: Clinical experience from 11 cases

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