Microsurgical reconstruction: the weightbearing surface of the foot

Microsurgical reconstruction in the weightbearing surface of the foot is discussed. Thirty-eight patients treated at the Mayo Clinic are reviewed as well as a review of the current literature, leaving 122 patients for analysis. Minor complication rates in the skin grafted muscle flaps were 18.5% and major complication rates requiring further surgery were found in 12.9%. Fasciocutaneous and cutaneous flaps had a 25% incidence of minor complications and a 26% incidence of major complications requiring further surgery. No definite conclusions can be drawn as to which flap is indeed the best, but the newer, thinner fasciocutaneous flaps with innervation seem to hold promise. Future considerations are also discussed.