The sensory function after repair of the sole defects / 中华骨科杂志

ABSTRACT

Objective To study the methods of repairing the sole defects and reconstruction of the sensory function. Methods Twenty- nine cases of sole defect were repaired with flaps and full- thickness grafting according to the weight- bearing area and non- weight- bearing area. Sixteen cases had reconstruction of the sensory nerves. Results Twenty- nine cases were followed up for 1－ 9 years. One case failed. One case required thinning the flap. Twenty- eight cases have gained normal weight bearing ambulation. Ulcer occurred in one case, giving an ulcer rate of 3.4％ . The sensation have recovered to S2－ S3 in 16 cases repaired with reconstruction of cutaneous sensory nerves. Thirteen cases repaired with non- innervated flaps and full- thickness grafting showed deep pain sensation, and over the 1－ 2 cm area coverage around the flaps there was light touch sensation. No significant difference was found in the ulcer rate between reinnervated and non- innervated flaps. Conclusion Defects of the weight- bearing area in sole must be repaired with flaps. The medial foot island flap, medial pedal island flap, toe arterial flap and anterolateral thigh flap are the appropriate options. Defects of the non- weight- bearing area could be repaired with full- thickness grafting. The transplantation of non- sensory skin flaps can re- establish the sensory function, so the reconstruction of sensory nerve is of minor importance.