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Lipofilling for functional reconstruction of the sole of the foot
Giovanni Nicoletti1, Federica Brenta2, Omar Jaber2
1Plastic and Reconstructive Surgery, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Via Aselli 45, 27100 Pavia, Italy; Plastic and Reconstructive Surgery Unit, Salvatore Maugeri Research and Care Institute, Via Salvatore Maugeri 10, 27100 Pavia, Italy; Advanced Technologies for Regenerative Medicine and Inductive Surgery Research Centre, University of Pavia, Viale Brambilla 74, 27100 Pavia, Italy.
Background:
New advances in regenerative surgery may increase the potential for rehabilitation in the injured foot.
Objectives:
A clinical prospective observational study was carried out to assess the effectiveness of lipofilling to improve the functional recovery of the injured foot.
Methods:
Four patients with anatomical-functional impairment following repair of post-traumatic soft tissue loss of the foot were involved in the study. All of the patients complained of pain in the repaired plantar weight bearing area, skin instability, recurrent ulcerations and were walking on crutches. A combined plastic surgery and technical orthopaedic assessment identified the plantar areas requiring anatomical changes for load redistribution. Two selective sequential lipofillings with a 12 weeks' time interval were performed. Manufacturing of custom-made plantar insoles and/or shoes followed each surgical procedure.
Results:
After the treatment all of the patients progressively recovered both a better plantar load distribution and a local soft tissue stability, referred the remission of chronic pain and discontinued the use of crutches.
Conclusion:
Lipofilling proved to be an effective and versatile surgical technique for both reconstructive and regenerative purposes. The interaction between the Plastic Surgery staff and the Orthopaedic Technician outlined a successful multidisciplinary approach model for the rehabilitation of the injured foot.
