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[Anatomically and biomechanically based treatment algorithm for foot and ankle soft tissue reconstruction].
M D Haug1, V Valderrabano, U M Rieger
1Abteilung für Plastische, Rekonstruktive und Asthetische Chirurgie, Klinik für Wiederherstellende Chirurgie, Universitätsspital Basel, Schweiz. mhaug@uhbs.ch
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|December 10, 2008
Summary
This study proposes a new algorithm for foot and ankle soft tissue reconstruction, dividing the region into functional zones based on pressure analysis. This approach aids in selecting the most effective surgical technique for diverse defects.
Area of Science:
- Orthopedic Surgery
- Plastic Surgery
- Biomedical Engineering
Background:
- Foot and ankle reconstruction presents challenges due to limited soft tissue and specific functional needs.
- Composite defects often require interdisciplinary collaboration.
- A unified treatment concept for severe foot soft tissue damage is lacking.
Observation:
- Pedobarographic gait analysis reveals distinct plantar pressure distribution zones.
- These zones inform a functional and anatomic subdivision of the foot and ankle.
- Consideration of pressure, tissue quality, shear forces, and vital structures is crucial.
Findings:
- The proposed algorithm effectively subdivides the foot and ankle based on functional and anatomic needs.
- The treatment algorithm integrates local, regional, and microsurgical reconstructive options.
- The algorithm's practicability is demonstrated through clinical cases.
Implications:
- Accurate timing and consideration of regional needs are vital for successful foot and ankle reconstruction.
- The algorithm facilitates the selection of optimal operative techniques for various defect sizes and locations.
- Restoration of sensibility, motor function, and aesthetics is the primary goal for plastic surgeons.