Restoring blood flow to the lateral plantar artery after elevation of an instep flap or medialis pedis flap

Jonathan Velazquez-Mujica*, Francesco Amendola, Davide Spadoni, Hung Chi Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

Abstract

The instep flap and medialis pedis flap are both originate based on the medial plantar artery. The medialis pedis flap is based from the deep branch and the instep flap is based from the superficial branch. To increase the axial rotation, it is acceptable to ligate the lateral plantar artery. However, this can partially affect the blood supply of the plantar metatarsal arch. We restored the blood flow with a vein graft between the posterior tibial artery and the ligated stump. From 2012 to 2020, 12 cases of heel reconstruction, including seven instep flaps and five medialis pedis flaps, were performed with ligation of the lateral plantar artery. The stump of the lateral plantar artery was restored with a vein graft and between the posterior tibial artery and the ligated stump. Patients were followed for 18 months. Long-term results showed the vascular restoration of the lateral plantar artery remained patent demonstrated by doppler ultrasonography. Restoring blood flow to the lateral plantar artery maintains good blood supply to the toes. If the patient in the future develops a chronic degenerative disease, with microvascular complications, bypass surgery can still be performed because of the pa-tency of both branches.

Original languageEnglish
Pages (from-to)80-85
Number of pages6
JournalArchives of Plastic Surgery
Volume49
Issue number1
DOIs
StatePublished - 01 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022.

Keywords

  • Foot ulcer
  • Melanoma
  • Perforator flap
  • Surgical flap

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