Anatomic basis and clinical application of the distally based medialis pedis flaps

作者：Song, Dajiang; Yang, Xiaodong; Wu, Zedong; Li, Lei; Wang, Tianquan; Zheng, Heping^*; Hou, Chunlin^*

来源：Surgical and Radiologic Anatomy, 2016, 38(2): 213-221.

DOI：10.1007/s00276-015-1532-6

• The first plantar metatarsal artery
• Medial plantar artery of the hallux
• Forefoot reconstruction

Background Soft-tissue defects of the forefoot are difficult to cover adequately, particularly, although multiple options for reconstruction are available. This study especially focused on the vascularization of the medial side of the foot and the determination of the contribution of the nutrient vessels to medialis pedis flap viability.
Methods Thirty cadavers were available for this anatomical study. Microdissection was conducted under a microscope, and details of the course and distribution and the communication of the first plantar metatarsal artery with the fascial vascular network of the medial side of the foot were recorded. Clinically, six cases of soft-tissue defects at the forefoot region were reconstructed with distally based medialis pedis flap.
Results The perforator of the first plantar metatarsal artery pierces in the superficial fascia of the medial aspect of the foot 2.2 +/- 0.7 cm proximal to the first metatarsophalangeal joint, vascularize the skin of the medial plantar region. The anatomical study showed that the vasculature pattern could roughly be classified into two types. In terms of clinical application, all flaps completely survived, and one patient had partial loss of skin graft.
Conclusion The perforators of the medialis pedis flap are presented constant. The forefoot region can be repaired by the distally based medialis pedis flap on the perforator of the medial plantar artery of the hallux or the first plantar metatarsal artery perforator with medial plantar vein, medial plantar cutaneous nerve and nutrient vessels.

• 出版日期2016-3
• 单位中南大学; 福建医科大学; 天津市中医药研究院附属医院; 中国人民解放军总医院; 湖南省肿瘤医院; 中国人民解放军第二军医大学