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Assessment of Plantar Flap Coverage at Various Foot Amputation Levels: A Cadaveric Study
Dominick Casciato1, Sara Mateen2, Sarah Mansager3
1*University of Maryland Medical Center, Baltimore, MD.
Background:
From traumatic injury to diabetic foot infections, minor amputations of the foot and ankle rely on viable and adequate soft-tissue coverage. When employing a plantar foot flap, coverage often determines amputation level. This study examined the relative plantar foot flap length needed to cover various levels of minor foot amputations.
Methods:
Demographic data and plantar flap length of ten cadaver specimens were recorded. The minimum plantar flap length needed to cover transmetatarsal, Lisfranc, and Chopart amputations was measured following each amputation. Absolute and percentage of total flap length were determined. The Pearson correlation coefficient among demographic and anthropometric data was calculated. The threshold for statistical significance was set at P ≤ .05. Among the 14 dissected cadavers, eight were male and six were female.
Results:
The height and weight were 177.21 ± 10.42 cm and 171.79 ± 58.18 pounds, respectively. The minimum percent lengths of the total plantar flap needed to cover transmetatarsal, Lisfranc, and Chopart amputations were 85.35 ± 3.75%, 75.31 ± 3.43%, and 63.55 ± 5.08%, respectively. There existed a statistically significant relationship between cadaver height and plantar flap needed to close Lisfranc (P = .04) and Chopart (P = .04) amputations.
Conclusions:
In the clinical and surgical setting, these results provide an estimation of the level of amputation based on available plantar flap length. Future studies may examine the application of these estimates both surgically and preoperatively when discussing predicted amputation level with patients.
