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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction

Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction

Published on: December 5, 2025

Heel reconstruction with free instep flap: a case report.

Lifeng Liu¹, Yu Zhou, Xuexin Cao

¹Orthopedic Department, General Hospital of Jinan Military Command, No,25, Shifan Road, Jinan 250031, China. doctorliu90@hotmail.com.

Journal of Medical Case Reports

|September 28, 2014

Summary

Reconstructing weight-bearing heel defects can be challenging. A free contralateral instep flap offers a viable solution, achieving excellent functional and aesthetic outcomes in selected cases.

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Area of Science:

Plastic Surgery
Reconstructive Surgery
Microsurgery

Background:

Weight-bearing heel defects pose significant reconstructive challenges due to plantar skin characteristics.
While instep flaps are ideal, ipsilateral flaps are unavailable when defects involve the instep area.
Free contralateral instep flaps present a potential solution but are infrequently reported.

Observation:

A case involving a 41-year-old Asian man with a soft-tissue lesion in the weight-bearing heel and instep area.
Reconstruction was performed using a free instep flap from the contralateral foot.
Vascular anastomosis involved the medial plantar artery to the posterior tibial artery, and nerve coaptation involved sensory fascicles to the medial plantar nerve.

Findings:

Successful flap survival without ulceration.
Excellent functional and aesthetic outcomes were observed at 30 months post-surgery.
The contralateral free instep flap demonstrated robust viability and integration.

Implications:

This technique provides a valuable option for weight-bearing heel reconstruction when local flaps are not feasible.
The contralateral free instep flap may become a preferred treatment in specific heel defect scenarios.
Further studies could explore the broader application and long-term efficacy of this reconstructive method.