RECONSTRUCTION OF THE PLANTAR AREA OF THE GREAT TOE WITH THE REVERSE MEDIAL PLANTER ISLAND FLAP

Rho, Bong Il; Kim, Jae Hoon; Kim, Jung Tae; Kim, Yong Bae; Yang, Soon Jae; Park, Jong Sup

Abstract

Reconstruction of the soft tissue defects on the plantar foot continues to be a difficult challenges because of the unique anatomical features. It should endure constant weight loading or alternate stimulus of shoes while standing or walking. The methods used for reconstruction of the soft tissue defects on the plantar foot are skin graft, local flap, cross leg flap, myocutaneous flap, neurovascular island and free flap. However, it is verb difficult to find a proper method to reconstruct the soft tissue defect of the first toe plantar area. The ideal reconstruction should provide tissue as durable yet sensitive, provide tissue components similar to the original lost tissue, be reliable, result in a donor site that is well tolerated, and entail one operative procedure with minimal morbidity Although the medial plantar flap was initially described to surface heel defects, many surgeons haute used this flap as a cross leg flap or a free flap to recover the first toe plantar area. Its use has always required a secondary surgical procedure or a difficult technique. In order to overcome this inconvenience, we used the flap based on the principle of reversing the direction of blood flow in a distal vascular pedicle to restore a defect of the anteromedial aspect of the foot. We haute experienced 3 cases of reverse medial plantar flap for the reconstruction of the great toe plantar area. Good functional and aesthetic results were obtained.