Defects of the heel, whether through trauma or disease, present serious problems when considering the weight bearing pressure and continuous friction. Up to the date, many surgical modalities from a skin graft to the free flap have been developed, but no complete satisfactory method of reconstruction has yet been found.
The ideal reconstructive technique should provide tissue with sufficient padding and sensibility when the considerable size of defect is located on plantar surface of weight bearing area.
In addition, many surgical modalities such as local flaps, myocutaneous flaps and myocutaneous island flaps using the non-weight-bearing area between the heel and metatarsal heads have been developed in the concept of "losses must be replaced in kinds". But in the local flap, the indication is limited when the size of the defect is large, and in the flap containing the muscle, the secondary defect is devastating and the function of the muscle is not preserved. So we have a good results by using a true midplantar fasciocutaneous island flap without muscle in one stage for heel defects.
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