Original ResearchFree and Pedicled Flaps for Reconstruction of the Weightbearing Sole of the Foot: A Comparative Analysis of Functional Results
Section snippets
Patients and Methods
The present retrospective study included 37 patients treated for defects in the weightbearing plantar area with either free or pedicled flaps from 2001 to 2010 in our clinic. These flaps were performed in 37 patients during the study period. After analyzing the medical history, we excluded 9 of the 37 patients because of death (n = 1), major amputation (n = 2), multidrug resistant bacteria infection (n = 2), and immobility (n = 4). In addition, 4 patients were lost to follow-up, and 3 refused
Results
In the present study, 12 free and 9 pedicled flap reconstructions were performed (Table 1 and Fig. 2). Of those, 13 were fasciocutaneous, 4 adipocutaneous, 2 myofasciocutaneous, and 2 were muscle flaps with split-thickness skin grafts (Fig. 3). None of the free flaps was transferred with sensory nerve coaptation.
No complete flap loss was seen. One medial plantar artery flap required revision because of hematoma. Most of the defects had been caused by trauma and were located in the heel region (
Discussion
In the recent medical data, the different approaches concerning the best flap types for reconstruction of the weightbearing sole of the foot and necessity for reinnervation have been controversial. Owing to the low number and heterogeneity of these patients, it would be very difficult to design a prospective study. Follow-up studies that have included pedobarographic gait analyses are rare. Perttunen et al (15) examined 7 patients, and Meyer-Marcotty et al (16) examined 8 patients. Both studies
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