The rotational advancement of medial plantar flap for coverage of foot defect: A case report

Beidas, Omar E.; Tan, Benny Kwong Huat; Petersen, J. Dayne

doi:10.1002/micr.21956

Cited by 9 publications

(13 citation statements)

References 23 publications

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“…7 Beidas et al described a case report in which the posterior tibial and lateral plantar arteries were too small to elevate a retrograde-flow medial plantar flap. 18 Based on the results of cadaver dissection in the present report, there was no specimen in whom the lateral plantar artery was very small; however, pre-operative imaging methods such as color Doppler sonography might be useful to detect cases unsuitable for this novel surgical procedure.…”

Section: Discussionmentioning

confidence: 72%

Reconstruction of the great toe using a pedicled medial plantar flap with anterograde venous drainage

et al. 2014

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Section: Discussionmentioning

confidence: 72%

Reconstruction of the great toe using a pedicled medial plantar flap with anterograde venous drainage

et al. 2014

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“…It is difficult for the pedicled flaps to reach this area. Beidas used a rotational medial plantar flap to cover a small size defect in this area . However, since the donor site of the medial plantar flap was often included in the injury zone, a free flap was usually selected for reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…However, since the size of the medial plantar flap is small, this flap was only chosen for reconstruction of small size defects of the heel. 1,12,27 If the entire calcaneus tubercle was exposed, the pedicled flaps may have size limited. A free anterolateral thigh perforator flap was usually used in our series.…”

Section: Discussionmentioning

confidence: 99%

“…This option includes the use of pedicled flaps from the leg and foot and free flaps from various parts of the body. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Based on Hollenbeck's principle, 19 The ankle is divided into 2 subunits: lateral malleolus and medial malleolus. The dorsal foot is divided into 3 subunits: dorsal hind foot, dorsal midfoot, and dorsal forefoot.…”

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confidence: 99%

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Foot and ankle reconstruction: An experience on the use of 14 different flaps in 226 cases

Zhu

Wang

et al. 2013

Microsurgery

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The aim of this report was to present our experience on the use of different flaps for soft tissue reconstruction of the foot and ankle. From 2007 to 2012, the soft tissue defects of traumatic injuries of the foot and ankle were reconstructed using 14 different flaps in 226 cases (162 male and 64 female). There were 62 pedicled flaps and 164 free flaps used in reconstruction. The pedicled flaps included sural flap, saphenous flap, dorsal pedal neurocutaneous flap, pedicled peroneal artery perforator flap, pedicled tibial artery perforator flap, and medial plantar flap. The free flaps were latissimus musculocutaneous flap, anterolateral thigh musculocutaneous flap, groin flap, lateral arm flap, anterolateral thigh perforator flap, peroneal artery perforator flap, thoracdorsal artery perforator flap, medial arm perforator flap. The sensory nerve coaptation was not performed for all of flaps. One hundred and ninety-four cases were combined with open fractures. One hundred and sixty-two cases had tendon. Among 164 free flaps, 8 flaps were completely lost, in which the defects were managed by the secondary procedures. Among the 57 flaps for plantar foot coverage (25 pedicled flaps and 32 free flaps), ulcers were developed in 5 pedicled flaps and 6 free flaps after weight bearing, and infection was found in 14 flaps. The donor site complications were seen in 3 cases with the free anterolateral thigh perforator flap transfer. All of limbs were preserved and the patients regained walking and daily activities. All of patients except for one regained protective sensation from 3 to 12 months postoperatively. Our experience showed that the sural flap and saphenous flap could be good options for the coverage of the defects at malleolus, dorsal hindfoot and midfoot. Plantar foot, forefoot and large size defects could be reconstructed with free anterolateral thigh perforator flap. For the infected wounds with dead spce, the free latissimus dorsi musculocutaneous flap remained to be the optimal choice.

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“…As described by Martin et al (1991) in their paper, by tailoring in a "Y to V" fashion, the MP flap pedicle, a considerable gain in the arc of rotation can be obtained permitting coverage of more distant defects of the plantar foot. One of the main disadvantages of this flap, as in other reverse-flow variants of the MP flap (Oberlin, Accioli de Vasconcellos, & Touam, 2000), is an unreliable venous drainage (Acikel, Celikoz, Yuksel, & Ergun, 2003;Akita et al, 2014;Beidas, Tan, & Petersen, 2012;Masuoka & Kato, 2004;Park, Lee, Lee, & Baek, 2017).…”

Section: Introductionmentioning

confidence: 99%

The bipedicled medial plantar flap: Vascular enhancement of a reverse flow Y–V medial plantar flap by the inclusion of a metatarsal artery perforator for the reconstruction of a forefoot defect—A case report

et al. 2017

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The pedicled medial plantar (MP) flap is an optimal solution for defects involving the weight-bearing areas of the foot. However, venous congestion is a frequently encountered complication, especially with the reverse-flow variants of the flap, and several strategies have been reported in literature both to prevent and to manage it. In this article, we present the use of a medial plantar flap based distally on the lateral plantar artery with the adjunct of an extra metatarsal perforator from the dorsalis pedis artery as a vascular enhancement to avoid the venous congestion and to improve the overall circulation. This bipedicled flap was successfully advanced to cover a 5 × 3 cm soft-tissue defect located at the level of the first and second metatarsal heads of the right foot resulting from the excision of a squamous cell carcinoma in an 80-year-old male patient with a history of cardiovascular disease. The postoperative course was uneventful. The patient was discharged 7 days after the operation and was able to walk after 6 weeks wearing normal shoes. We believe that preserving plantar metatarsal perforators during the harvesting of an MP flap based distally on the lateral plantar artery may be a precious adjunct as it increases blood supply, especially the venous drainage of the flap.

show abstract

The rotational advancement of medial plantar flap for coverage of foot defect: A case report

Cited by 9 publications

References 23 publications

Reconstruction of the great toe using a pedicled medial plantar flap with anterograde venous drainage

Reconstruction of the great toe using a pedicled medial plantar flap with anterograde venous drainage

Foot and ankle reconstruction: An experience on the use of 14 different flaps in 226 cases

The bipedicled medial plantar flap: Vascular enhancement of a reverse flow Y–V medial plantar flap by the inclusion of a metatarsal artery perforator for the reconstruction of a forefoot defect—A case report

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