Reconstruction of traumatic plantar foot defects in diabetic patients

Luca Vaienti, Giovanni Palitta, Giovanni Ravasio, Pietro Randelli, Paolo Arrigoni

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Plantar reconstruction is often challenging for plastic surgeons because of the peculiar anatomical features of this region. A large variety of reconstructive techniques for the plantar aspect of the foot have been described previously, including skin grafts, local flaps, fasciocutaneous flaps, perforator flaps, cross-limb flaps, and free flaps. This article presents a case of a 64-year-old patient with insulin-dependent diabetes who was involved in a traffic accident that resulted in a large plantar tissue defect (9x4 cm) extending to the base of the toes. After debridement of the wound, a subcutaneous flap was raised from the medial aspect of the lower leg in a suprafascial plane. The flap was based on a double vascularization given by the great saphenous vein and by the perforator vessels from the posterior tibial artery, located anteriorly and inferiorly to the medial malleolus. The flap showed excellent vitality and long-term result with reduced donor site morbidity. We believe this flap represents a reliable surgical option in superficial plantar defects due to easy harvesting, short operative time, and minimal donor site morbidity. The subcutaneous flap of the distal medial fourth of the leg is a safe technique because of the vascular components of the pedicle. It provides durable coverage, mechanical resistance to pressure and shear stresses and, in selected cases (superficial defects, thin patients), is an interesting option to avoid major free flap procedures.

Original languageEnglish
JournalOrthopedics
Volume33
Issue number5
DOIs
Publication statusPublished - May 1 2010

Fingerprint

Free Tissue Flaps
Foot
Leg
Tissue Donors
Tibial Arteries
Perforator Flap
Morbidity
Traffic Accidents
Saphenous Vein
Toes
Debridement
Operative Time
Blood Vessels
Extremities
Insulin
Transplants
Pressure
Skin
Wounds and Injuries
Surgeons

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Vaienti, L., Palitta, G., Ravasio, G., Randelli, P., & Arrigoni, P. (2010). Reconstruction of traumatic plantar foot defects in diabetic patients. Orthopedics, 33(5). https://doi.org/10.3928/01477447-20100329-24

Reconstruction of traumatic plantar foot defects in diabetic patients. / Vaienti, Luca; Palitta, Giovanni; Ravasio, Giovanni; Randelli, Pietro; Arrigoni, Paolo.

In: Orthopedics, Vol. 33, No. 5, 01.05.2010.

Research output: Contribution to journalArticle

Vaienti, L, Palitta, G, Ravasio, G, Randelli, P & Arrigoni, P 2010, 'Reconstruction of traumatic plantar foot defects in diabetic patients', Orthopedics, vol. 33, no. 5. https://doi.org/10.3928/01477447-20100329-24
Vaienti, Luca ; Palitta, Giovanni ; Ravasio, Giovanni ; Randelli, Pietro ; Arrigoni, Paolo. / Reconstruction of traumatic plantar foot defects in diabetic patients. In: Orthopedics. 2010 ; Vol. 33, No. 5.
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