Intact sensation constitutes an important protective mechanism for the plantar surface of the foot. For optimal functional results, sensory reinnervation in reconstruction of the heel of the plantar foot would appear to be helpful. Various techniques are presented in which both intact local tissue and distant tissue are used. The design of neurosensory fasciocutaneous flaps and musculocutaneous flaps from the foot, sensory-innervated full thickness skin grafts, and microsurgically transferred skin flaps, muscle flaps, and musculocutaneous flaps are presented. Free tissue transfer techniques can be used in combination with various sensory reinnervation techniques.
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References
1.
. BostwickJ.III: Reconstruction of the heel pad by muscle transposition and split skin graft. Surg. Gynecol. Obstet., 143:973, 1976.
2.
. CohenL.B.BunckeH.: Neurovascular island flap from the plantar vessels and nerves for foot reconstruction. Ann. Plast. Surg., 4:327, 1984.
3.
. DuncanM.J.ZukerR.M.ManktelowR.T.: Resurfacing weight bearing area of the heel—the role of dorsalis pedis innervated free tissue transfer. J. Reconstr. Micro., 1:201, 1985.
4.
. FranklinJ.: The deltoid flap: anatomy and clinical application. In Symposium in Clinical Frontiers in Reconstructive Microsurgery. BunckeH.J.FurnasD. (eds.), St. Louis: C. V. Mosby, 1984, p. 63.
5.
. GerR.: The surgical management of the ulcer of the heel. Surg. Gynecol. Obstet., 140:909, 1975.
6.
. HarrisonD.MorganB.: The instep island flap to resurface plantar defects. Br. J. Plast. Surg., 34:315, 1981.
7.
. HartrampfC.K.Jr.ScheflanM.BostwickJ.III: The flexor digitorium brevis muscle island pedicle flap: a new dimension in heel reconstruction. Plast. Reconstr. Surg., 66:264, 1980.
8.
. HartwellS.W.Jr.: Local flaps of the leg and foot. In Skin Flaps. GrubbW.C.MyersM.B. (eds.), Boston:Little, Brown, 1975, p. 497.
9.
. HidalgoD.A.ShawW.: The anatomical basis of plantar flap design. Plastic Surg. Forum, 8:163, 1985.
10.
. IkutaY.MurakamiT.YoshiokaK.TsugeK.: Reconstruction of the heel pad by flexor digitorum brevis musculocutaneous flap transfer. Plast. Reconstr. Surg., 74:86, 1984.
11.
. ListerG.D.: Use of an innervated skin graft to provide sensation to the reconstructed heel. Plast. Reconstr. Surg., 62:157, 1978.
12.
. MaiselD.O.: Repairs of heel. Br. J. Plast. Surg. 14:117, 1964.
13.
. MaquieiraN.O.: An innervated full thickness skin graft to restore sensibility to fingertip and heel. Plast. Reconstr. Surg., 53:568, 1974.
14.
. MayJ.W.HallsM.J.SimonS.R.: Free microvascular muscle flaps with skin graft reconstruction of extensive defects of the foot: a clinical and gait analysis study. Plast. Reconstr. Surg., 75:627, 1985.
15.
. McCarthyJ.G.: Subfascial arterialized sole of the foot flap. Plast. Reconstr. Surg., 73:691, 1984.
16.
. MorrisA.M.BuchanA.C.: The place of cross-leg flap in reconstructive surgery of the lower leg and foot: a review of 165 cases. Br. J. Plast. Surg., 31:138, 1978.
17.
. MorrisonW.A.CrabbD.K.O'BrienB.Anid JenkinA.L.: The instep of the foot as a fasciocutaneous and as a free flap for heel defect. Plast. Reconstr. Surg., 72:56, 1983.
18.
. MulbauerW.HerndlE.StockW.: The forearm flap. Plast. Reconstr. Surg., 70:336, 1982.
19.
. NahaiF.HillL.H.HesterT.R.: Experience with the tensor fascia lata flap. Plast. Reconstr. Surg., 63:788, 1979.
20.
. RaineT.J.NahaiF.: Free transfer to the foot: a review of 28 cases over 7 years. Plast. Surg. Forum, 7:112, 1984.
21.
. SommerladB.C.McGroutherD.A.: Resurfacing the sole: long-term followup and comparison of techniques. Br. J. Plast. Surg., 31:107, 1978.
