Medial Plantar Artery Flap for Heel Reconstruction: A Retrospective Observational Study

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Heel defect reconstruction is complex due to the need for both weight-bearing capacity and protective sensation.
• The medial plantar artery (MPA) flap offers a durable, sensate option closely mimicking the native heel pad.

Purpose of the Study:

• To evaluate the efficacy and outcomes of medial plantar artery (MPA) flaps for heel reconstruction.
• To assess flap survival, sensory recovery, and functional results in patients undergoing MPA flap surgery.

Main Methods:

• Retrospective observational study of 15 patients undergoing heel reconstruction with MPA flaps.
• Data collected on demographics, etiology, flap survival, sensory recovery, and postoperative outcomes between January 2021 and December 2024.
• Evaluation of functional results including weight-bearing ability and protective sensation.

Main Results:

• Fifteen patients (11 male, 4 female; mean age 54.66 years) with various heel defects (trauma, malignancy, ulcers) were treated.
• High flap survival rate with only one case of partial distal flap necrosis, managed conservatively.
• All patients achieved protective sensation and successful weight-bearing post-reconstruction.

Conclusions:

• The medial plantar artery (MPA) flap is a reliable and effective reconstructive choice for plantar heel defects.
• It provides favorable functional outcomes, including sensation and weight-bearing capability, with minimal donor site morbidity.
• MPA flaps are ideal for moderate-sized defects, closely resembling the native heel pad structure.