Volume : 7, Issue : 6, June - 2018

RECONSTRUCTION OF PLANTAR FOOT DEFECTS USING MEDIAL PLANTAR ARTERY FLAP: OUR EXPERIENCE

Dr. R Vivek, Dr. Janhavi Venkataraman, Dr. B Senthil Kumaran, Prof. J Jagan Mohan

Abstract :

<p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Background</span></u></b><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">:<span style="mso-spacerun:yes">&nbsp; </span>Reconstruction of full-thickness plantar foot defects present a challenge to surgeons.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><span lang="EN-IN" style="font-size:14.0pt;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;">These defects ideally should be reconstructed with durable sensate tissue. Despite the numerous procedures that have been described for resurfacing these plantar, to achieve a sensate foot with normal function still remains an intricate task.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><span lang="EN-IN" style="font-size:14.0pt;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;">We present our clinical experience of plantar foot defects reconstructed using medial plantar artery flap.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><span lang="EN-IN" style="font-size:14.0pt;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p>&nbsp;</o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Methods</span></u></b><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: 18 patients with defects of the plantar surface of the foot were reconstructed using medial plantar artery flap.</span><span lang="EN-IN" style="font-size:14.0pt;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;;&#10;mso-fareast-language:EN-IN">All the flaps were raised as sensate fasciocutaneouspedicled flaps based on the medial plantar artery.</span><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> The donor site was closed using a split thickness graft.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><span lang="EN-IN" style="font-size:14.0pt;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p>&nbsp;</o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Results</span></u></b><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: In 13 patients the defect healed with good results and no complications within 4 weeks, 3 patients presented with superficial epidermolysis in the periphery and 1 patient had a flap loss. 2 patients had partial graft loss in the secondary defect.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><span lang="EN-IN" style="font-size:14.0pt;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p>&nbsp;</o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:-30.65pt;margin-bottom:&#10;0in;margin-left:0in;margin-bottom:.0001pt;line-height:normal;mso-layout-grid-align:&#10;none;text-autospace:none"><b style="mso-bidi-font-weight:normal"><u><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Conclusion</span></u></b><span lang="EN-IN" style="font-size:14.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">: In our experience medial plantar artery flap cover is a durable option for sole defects with acceptable aesthetic and functional outcomes. Donor site morbidity is minimal. This flap is a safe reliable and technically easy alternative flap coverage for plantar defects especially around the heel.<o:p></o:p></span></p>