Abstract
The goal for foot reconstruction is to restore the structure and walking function. To achieve this goal, it is important to assess precisely the defects in anatomical structure, residual function, reconstructive procedure, and postoperative therapy, including rehabilitation and fitting of braces or footwear. We experienced twelve free tissue transfers and thirteen pedicle skin flaps for foot reconstruction in our hospital or branch hospitals. In all cases, tailored braces or footwear were used postoperatively under advice from a prosthetist. The free flaps we selected were: one rectus abdominis musculo-cutaneous flap, six latissimus dorsi musculo-cutaneous flaps, three groin flaps, a free scalp flap, and a scapular flap. Two of the patients who underwent free latissimus dorsi musculo-cutaneous transfer had a failed procedure due to vascular thrombus. The pedicled flaps we used were: six distally based sural flaps, five medial plantar flaps, and two lateral calcaneal flaps. Partial flap necrosis was encountered in two of six distally based sural flaps. Ulceration developed in one flap due to bulkiness. As restoring foot contour is ideal for foot reconstruction, we conclude that using thin flaps or thinning of flaps avoids bulkiness. Subsequent footwear fitting is also very important.
