The foot has unique anatomic and functional characteristics, it endures constant weight loading or alternation stimulus of shoes while standing or walking. So the foot is the challening area for reconstructive surgeons.
I have reconstructed 23 cases of foot defects with various island or free flaps from march 1990 to Feb. 1995. The patients exhibited variable causes and sizes of foot defects, 15 cases of acute trauma, 3 cases of skin cancer, 2 cases of scar
contacture,
2 cases of pressure sore and a case of diabetic ulcer. Free flaps were chosen in 10 cases, such as lateral arm flap, scapular flap, latissimus dorsi muscle flap, gracilis muscle flap, forearm flap and superficial temporal fascia flap. Island
flaps
were
also chosen in 13 cases such as medial plantar flap, dorsalis pedis flap, reverse peroneal flap, posterior tibial flap. All flaps were survived without necrosis. 23 cases were divided into 4 groups according to foot defect area, 9 cases of heel
and
plantar weight-bearing area, 3 cases of Ahcilles tendon area, 6 cases of medial and alteral malleolar area and 5 cases of dorsal foot. I recommend that medial plantar island flap is suitable for heel reconstruction, reverse peroneal island flap
for
Archiles thedon area, dorsalis pedis island flap for malleolar area, superficial temporal fascia free flap for dorsal foot.
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