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Medial Plantar Flap for Soft Tissue Reconstruction of the Lower Extremity: A Report of Three Cases
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M Ghoncheh *    |
| 1.Department of Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R.Iran. , mahdighoncheh@gmail.com |
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Abstract: (27 Views) |
Background and Objective: Reconstruction of soft tissue defects in the heel and Achilles tendon region requires the use of tissues that are capable of bearing body weight and are flexible enough to accommodate the gliding movements of the tendon. Additionally, the flap volume should not interfere with the patient's ability to wear shoes. Since the use of free flaps requires microvascular surgical experience and equipment, is often associated with longer operative times, and may not be feasible in some patients, this study aims to report three cases of medial plantar flap used for soft tissue reconstruction of the lower extremity.
Case Reports: This study reports the demographic data and surgical outcomes of three patients with heel and Achilles tendon wounds who underwent surgery using the medial plantar flap at Imam Reza Hospital in Birjand, Iran, between 2016 and 2023. All three patients were male. The reasons for referral were Marjolin's ulcer in one patient, traumatic wound in another, and malignant melanoma in the third. The mean age of the patients was 43.7±25.1 years (range: 16-65 years). The primary soft tissue defect requiring flap coverage was located in the heel region in two patients and in the Achilles tendon region in one patient. The mean soft tissue defect size was 25±5 cm². In all three patients, after the defect was covered using the medial plantar flap, the donor site was simultaneously covered with a split-thickness skin graft harvested from the thigh. During postoperative follow-up, no flap necrosis was observed in any patient. One patient developed minor necrosis at the skin graft site (donor site), which healed with conservative management. Overall, the healing process was satisfactory in all three patients, with no major complications.
Conclusion: Based on the findings of this study, the medial plantar flap is a reliable flap with low morbidity and can be used effectively for the reconstruction of soft tissue defects in the heel and Achilles tendon region. |
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| Keywords: Medial Plantar Flap, Free Flap, Soft Tissue Defects, Lower Extremity. |
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Type of Study: Cohort |
Subject:
Orthopedics
Received: 2025/02/10 | Accepted: 2025/05/5
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