Instep free flap for plantar soft tissue reconstruction: Indications and options

✍ Scribed by Oliver Scheufler; Daniel Kalbermatten; Gerhard Pierer

• Book ID: 102508785
• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 407 KB
• Volume: 27
• Category: Article
• ISSN: 0738-1085
• DOI: 10.1002/micr.20327

✦ Synopsis

Pedicled instep flaps are frequently used in weight-bearing plantar reconstruction, but may not be available after severe foot injuries. Although free instep flaps offer a viable option, they have scarcely been reported. A posttraumatic plantar forefoot defect was reconstructed with a sensate, instep free flap, because local flaps were not available and defect size did not require a distant free flap, and the current literature was reviewed for therapeutic options. The instep free flap yielded an excellent functional and aesthetic long-term result. In the literature, pedicled instep flaps are advocated for moderate size defects of the weight-bearing heel and sole, while free flaps from distant sites are preferred for large defects. Although skin-grafted muscle flaps and fasciocutaneous flaps yield similar results, reconstruction by like tissues appears favorable. We suggest the instep free flap for weight-bearing plantar foot reconstruction, when pedicled instep flaps are not available and distant free flaps are avoidable.