Special Topic·Plastic Surgery Repair of Trauma·Practice and Skill Innovations
Repair of heel soft tissue defect in children with free medial plantar flap with nerve
Yang Xuelin, Liu Chun, Hu Fuxing, Wang Qiang
Published 2021-11-25
Cite as Chin J Plast Surg, 2021, 37(11): 1251-1255. DOI: 10.3760/cma.j.cn114453-20200127-00021
Abstract
ObjectiveTo explore the method and clinical effect of the free medial plantar flap with the nerve in the reconstruction of skin and soft tissue defect of heel in children.
MethodsA series of retrospective analyses was conducted on the cases with heel skin and soft tissue defects admitted to the 89th Hospital of the PLA from July 2014 to February 2019. The medial plantar skin flap with cutaneous branches of the medial plantar nerve was harvested from the healthy side and transferred to the opposite side to repair the soft tissue defect of the heel of children. Then, the free skin graft was taken from the groin area to cover the donor site, and the wound was sutured directly. The appearance, texture, and color of the flap were observed, and the sensory recovery of the flap was evaluated two years after the operation. The functional condition was elevated by the American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot function scoring system.
ResultsA total of 6 children with heel skin and soft tissue defects were enrolled, including 4 males and 2 females, aged from 3 to 13 years.There were 4 cases on the right, and 2 cases on the left side, the size of skin and soft tissue defect was 2 cm×3 cm-6 cm×7 cm. All 6 flaps survived, the skin graft area healed in one stage, and the size of the flap was 3 cm×4 cm-7 cm×8 cm. The patients were followed up for 2-3 years. The appearance of the flap was not bloated, the color and texture of the flap were similar to the surrounding tissue, and the pedicle was flat. The two-point discrimination of the flap was 5-10 mm, with an average of 7 mm. There were only pigmentation and no obvious scar in the donor site of the uninjured foot. The ankle joint function was evaluated according to the American Association of foot and ankle surgery : 4 cases were excellent and 2 cases were good.
ConclusionsThe free medial plantar flap with the nerve is similar to the heel tissue, with reliable blood supply, no damage to the main blood vessels, and good sensory recovery after transplantation. It is an ideal flap for repairing heel soft-tissue defects in children.
Key words:
Surgical flaps; Nerve; Medial plantar flap; Heel; Children; Repair
Contributor Information
Yang Xuelin
Department of Burn and Plastic Surgery, No.89 Hospital of PLA, Weifang 261021, China
Liu Chun
Department of General Surgery, Weifang Municipal Hospital, Weifang 261021, China
Hu Fuxing
Department of Burn and Plastic Surgery, No.89 Hospital of PLA, Weifang 261021, China
Wang Qiang
Department of Burn and Plastic Surgery, No.89 Hospital of PLA, Weifang 261021, China
