Rotation Fasciocutaneous Flap with Z - Plasty: Clinical Applications for Reconstruction of the Lower Leg

The reconstruction of foot remains difficult due to its unique structure, insufficient local soft tissue and poor vascularity in spite of many surgical modalities. The medial plantar island flap enables to obtain sensate and structurally similar tissue with single operative procedure. We reconstructed 5 cases of soft tissue defects on foot by using medial plantar island flap(3 cases proximally- based, 2 cases distally-based) in diabetics. Successful soft tissue coverage was achieved on medial malleolus, dorsal midfoot, tendo calcaneus, and forefoot. The size of the flap ranged from 3.5 x 3.0 cm to 6.0 x 4.0 cm. The follow-up period ranged from 8 to 26 months. All flaps survived without serious complications. All patients gained confidence in daily activities and were able to ambulate in normal footwear. This paper demonstrates that medial plantar island flap with proximally and distally-based pedicle should be considered as a useful technique for reconstruction of soft tissue defect from ankle to forefoot.

Proximally and Distally-Based Medial Plantar Island Flap

The reconstruction of foot remains difficult problem with many surgical modalities because foot has unique structure, insufficient local soft tissue and poor vascularity. The medial plantar island flap is capable of providing sensate and structurally similar tissue with single operative procedure. We reconstructed 5 cases of soft tissue defects on the foot by using medial plantar island flap(3 cases proximally- based, 2 cases distally-based) in diabetics. Successful soft tissue coverage was achieved on medial malleolus, dorsal midfoot, tendo calcaneus, and forefoot. The size of flap ranged from 3.5 x 3.0 cm to 6.0 x 4.0 cm. Follow-up ranged from 8 months to 26 months. All flaps survived without serious complication. All patients had protective sensation in daily activities and were able to ambulate in normal footwear. This paper demonstrates that medial plantar island flap with proximally and distally-based pedicle should be considered as a useful technique for reconstruction of soft tissue defect from ankle to forefoot.