Effectiveness of Medial Plantar Artery and Reverse Sural Flaps in Plantar Foot Surface Reconstruction

Abstract

Background: Managing soft tissue defects of the foot and ankle poses a major challenge for reconstructive surgeons. The heel pad is vital for weight-bearing, shock absorption, and proprioception. Reconstruction is complicated by limited local tissue availability and poor blood supply.

Objective: To compare the effect of medial plantar artery flap (MPAF) versus reverse sural flap (RSF) in terms of flap survival in patients undergoing reconstruction of plantar surface of foot.

Study type, settings & duration: This comparative study was done at Department of Plastic & Reconstructive Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad from September 2021 to January 2023.

Methodology: Total of 160 patients underwent surgical procedure among two groups where 80 cases in each were enrolled. Patients underwent Medial Plantar Artery Flap in MPAF group, while RSF group patients underwent Reverse Sural Flap. Follow-up was done at one weekly intervals for one month and then monthly for up to 6 months. Patients were categorized as having poor, good and excellent outcome after 4 weeks of procedure.

Results: The mean age was 42.11±13.62 years. A total of 104 (65%) patients were male and 56 (35%) were female. In Medial plantar artery flap group excellent outcome was found among 72 (90%) of the patients, while among RSF group 63 (78.8%) patients achieved excellent outcome presenting a significant difference (p-value =0.021).

Conclusion: Excellent outcome was significantly higher among medial plantar artery flap group as compared to RSF in terms of flap survival in reconstruction of plantar surface of foot.