A neurovascular flap for coverage of distal plantar defects

Ulcers on the sole of the foot are very uncomfortable. A poor blood supply and a tendency to slow healing are common in these patients. Because of its weight-bearing and unique sensory function the glabrous skin of the sole is very specialized. To obtain a functional skin coverage, glabrous skin with a good blood supply and an intact nerve supply may be superior to other methods of soft tissue reconstruction. A neurovascular axial or island flap from the fibular side of the great toe may fulfill this demand with minimal donor site morbidity. Three cases are reported and the literature on the subject is summarized.