[Repair of heel defect with a free medial plantar flap]

The results of reconstruction of plantar heel defects with a local random flap or an island medial plantar flap have in a majority of cases been satisfactory. However, in cases of extensive plantar defects, local tissue transfers are almost impossible. Since 1988, 8 cases with extensive plantar defects have been treated using free medial plantar cutaneous or musculocutaneous flaps. All flaps survived. Six weeks postoperatively, full weight-bearing was obtained and normal activities were resumed. No ulceration in the flaps has been noted in the follow up period between 6 and 24 months, and the two point discrimination was from 20 to 24 mm. The paper particularly points out the importance of nerve repair in the reconstruction, because recovery of the protective sensation is the most important factor to prevent plantar ulceration, and is the basis for good operative results.