Heel reconstruction with free instep flap: a case report

详细信息    查看全文

• 作者：Lifeng Liu (7)
  Yu Zhou (7) (8)
  Xuexin Cao (7)
  Xuecheng Cao (7)
  Jinfang Cai (7)
  
  7. Orthopedic Department ; General Hospital of Jinan Military Command ; No.25 ; Shifan Road ; Jinan ; 250031 ; China
  8. Clinical Medicine Department ; Liaoning Medical College ; No.40 ; Songpo Road (3rd) ; Jinzhou ; 121001 ; China
  
• 关键词：Free instep flap ; Heel reconstruction ; Medial plantar artery ; Trauma
• 刊名：Journal of Medical Case Reports
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：8
• 期：1
• 全文大小：1,918 KB
• 参考文献：1. Benito-Ruiz, J, Yoon, T, Guisantes-Pintos, E, Monner, J, Serra-Renom, JM (2004) Reconstruction of soft-tissue defects of the heel with local fasciocutaneous flaps. Ann Plast Surg 52: pp. 380-384 CrossRef
  2. Yilmaz, M, Karatas, O, Barutcu, A (1998) The distally based superficial sural artery island flap: clinical experiences and modifications. Plast Reconstr Surg 102: pp. 2358-2367 CrossRef
  3. Baumeister, SP, Spierer, R, Erdmann, D, Sweis, R, Levin, LS, Germann, GK (2003) A realistic complication analysis of 70 sural artery flaps in a multimorbid patient group. Plast Reconstr Surg 112: pp. 129-142 CrossRef
  4. Harrison, DH, Morgan, BD (1981) The instep island flap to resurface plantar defects. Br J Plast Surg 34: pp. 315-318 CrossRef
  5. Taylor, GA, Hopson, WL (1975) The cross-foot flap. Plast Reconstr Surg 55: pp. 677-681 CrossRef
  6. Hasegawa, M, Torii, S, Katoh, H, Esaki, S (1994) The distally based superficial sural artery flap. Plast Reconstr Surg 93: pp. 1012-1020 CrossRef
  7. Masquelet, AC, Beveridge, J, Romana, C, Gerber, C (1988) The lateral supramalleolar flap. Plast Reconstr Surg 81: pp. 74-81 CrossRef
  8. Grabb, WC, Argenta, LC (1981) The lateral artery skin flap (the lateral calcaneal artery, lesser saphenous vein, and sural nerve skin flap). Plast Reconstr Surg 68: pp. 723-730 CrossRef
  9. Shanahan, RE, Gingrass, RP (1979) Medial plantar sensory flap for coverage of heel defects. Plast Reconstr Surg 64: pp. 295-298 CrossRef
  10. Kuran, I, Turgut, G, Bas, L, Ozkan, T, Bayri, O, Gulgonen, A (2000) Comparison between sensitive and nonsensitive free flaps in reconstruction of the heel and plantar area. Plast Reconstr Surg 105: pp. 574-580 CrossRef
  11. Mourougayan, V (2006) Medial plantar artery (instep flap) flap. Ann Plast Surg 56: pp. 160-163 CrossRef
  12. Morrison, WA, Crabb, DM, O鈥橞rien, BM, Jenkins, A (1983) The instep of the foot as a fasciocutaneous island and as a free flap for heel defects. Plast Reconstr Surg 72: pp. 56-65 CrossRef
  13. Wan, DC, Gabbay, J, Levi, B, Boyd, JB, Granzow, JW (2011) Quality of innervation in sensate medial plantar flaps for heel reconstruction. Plast Reconstr Surg 127: pp. 723-730 CrossRef
  14. Scheufler, O, Kalbermatten, D, Pierer, G (2007) Instep free flap for plantar soft tissue reconstruction: indications and options. Microsurgery 27: pp. 174-180 CrossRef
  15. Lykoudis, EG, Seretis, K, Lykissas, MG (2013) Free sensate medial plantar flap for contralateral plantar forefoot reconstruction with flap reinnervation using end-to-side neurorrhaphy: a case report and literature review. Microsurgery 33: pp. 227-231 CrossRef
  
• 刊物主题：Medicine/Public Health, general; General Practice / Family Medicine; Public Health; Primary Care Medicine;
• 出版者：BioMed Central
• ISSN：1752-1947

文摘

Introduction Reconstruction of weight-bearing heel defects remains a challenge because of the unique characteristics of the plantar skin. Though numerous surgical reconstructive options have been reported, the instep flap represents an ideal option and seems to be more acceptable to patients than others. However, when the heel defect expands to the instep area, the ipsilateral instep is not available for flap elevation. A free instep flap harvested from the contralateral foot can be a good solution, but this method has been scarcely reported. Case presentation A 41-year-old Asian man presented to our institution with a soft-tissue lesion in the weight-bearing heel and instep area. His heel was reconstructed with a free instep flap from the other foot, end-to-side anastomosis of its medial plantar artery to the recipient posterior tibial artery and end-to-side coaptation of the cutaneous sensory fascicles of the flap to the medial plantar nerve. Conclusion The flap survived successfully, and no ulceration occurred in the flap. At the last follow-up appointment at 30 months post-surgery, a very good functional and aesthetic outcome was verified, indicating that the suggested approach may prove to be the treatment of choice in selected cases of weight-bearing heel reconstruction.