2012 年 25 巻 3 号 p. 138-144
As a treatment for traumatic soft tissue defects of the foot, amputation results in a deteriorated quality of life because of a shortened leg. From April 2008 to March 2010, we performed reconstructions using free pedicled flaps based on the subscapular artery vasculature for three male patients with soft tissue defects of the foot. The mean age of the three patients was 52.0 years (range, 32-77 years). We used scapular flaps for two cases and a latissimus dorsi myocutaneous flap with scapular bone for one case. All flaps survived the procedure. After reconstruction, all patients could walk bearing their full weight. None of the patients showed any signs of skin trouble on the flap, such as ulceration or occurrence of clavi. Because of discrepancies in subcutaneous tissue thickness between donor and recipient tissue and difficulty with sensory reconstruction, only a few reports have found these types of flaps useful for foot reconstruction. In our cases, the patients were able to walk wearing normal shoes without developing any ulcers or clavi. We therefore conclude that scapular or latissimus dorsi myocutaneous flaps could be useful for soft tissue reconstruction of injured feet.