eMedicine Specialties > Plastic Surgery > Lower Extremity Reconstruction

Lower Extremity Reconstruction, Foot: Multimedia

Author: Fabio Santanelli, MD, PhD, Associate Professor of Plastic Surgery, University of Rome; Chief of Unita Operativa Dipartimentale di Chirurgia Plastica, Azienda Ospedaliera, Sant'Andrea, Rome
Coauthor(s): Francesca Romana Grippaudo, MD, Assistant Professor, Unit of Plastic Surgery, 2nd Medical Faculty, Sapienza University of Rome, Italy; Stefania Tenna, MD, Consulting Staff, Department of Plastic Surgery, University of Rome Policlinico Umberto I, Italy; Guido Paolini, MD, Plastic Surgery Unit, Assistant Professor of Plastic Surgery, Sant'Andrea Hospital- University of Rome La Sapienza -Italy; Emanuele Cigna, MD, Consultant Plastic Surgeon, Department of Plastic and Reconstructive Surgery, University of Rome La Sapienza, Italy
Contributor Information and Disclosures

Updated: Jun 26, 2008

Multimedia

Different evolutions of the foot in primates.Media file 1: Different evolutions of the foot in primates.
Different evolutions of the foot in primates.

Different evolutions of the foot in primates.

View of the 2 arches of the foot.Media file 2: View of the 2 arches of the foot.
View of the 2 arches of the foot.

View of the 2 arches of the foot.

Lateral and medial views of the vectors.Media file 3: Lateral and medial views of the vectors.
Lateral and medial views of the vectors.

Lateral and medial views of the vectors.

Xeroradiography shows the dispositions of the sha...Media file 4: Xeroradiography shows the dispositions of the shafts and the 2 arches theory.
Xeroradiography shows the dispositions of the sha...

Xeroradiography shows the dispositions of the shafts and the 2 arches theory.

Radiograph illustrating the dispositions of the s...Media file 5: Radiograph illustrating the dispositions of the shafts in the ankle joint and the heel.
Radiograph illustrating the dispositions of the s...

Radiograph illustrating the dispositions of the shafts in the ankle joint and the heel.

Computerized baropodometry of the foot. Views of ...Media file 6: Computerized baropodometry of the foot. Views of the different pressure levels.
Computerized baropodometry of the foot. Views of ...

Computerized baropodometry of the foot. Views of the different pressure levels.

Nuclear magnetic resonance of the foot. This exam...Media file 7: Nuclear magnetic resonance of the foot. This examination best shows bone, joints, and ligaments as well as the soft tissues. Nuclear magnetic resonance is important when making the diagnosis in ankle or heel diseases.
Nuclear magnetic resonance of the foot. This exam...

Nuclear magnetic resonance of the foot. This examination best shows bone, joints, and ligaments as well as the soft tissues. Nuclear magnetic resonance is important when making the diagnosis in ankle or heel diseases.

Medial plantar flap, instep flap (O'Brien and Sha...Media file 8: Medial plantar flap, instep flap (O'Brien and Shanahan, 1979).
Medial plantar flap, instep flap (O'Brien and Sha...

Medial plantar flap, instep flap (O'Brien and Shanahan, 1979).

Dorsalis pedis flap, described by McCraw and Furl...Media file 9: Dorsalis pedis flap, described by McCraw and Furlow (1975).
Dorsalis pedis flap, described by McCraw and Furl...

Dorsalis pedis flap, described by McCraw and Furlow (1975).

Medialis pedis flap described by Masquelet (1990).Media file 10: Medialis pedis flap described by Masquelet (1990).
Medialis pedis flap described by Masquelet (1990).

Medialis pedis flap described by Masquelet (1990).

Lateral calcaneal artery skin flap, described by ...Media file 11: Lateral calcaneal artery skin flap, described by Grabb and Argenta (1981).
Lateral calcaneal artery skin flap, described by ...

Lateral calcaneal artery skin flap, described by Grabb and Argenta (1981).

Sural flap; perforator flap from peroneal artery;...Media file 12: Sural flap; perforator flap from peroneal artery; described by Donski and Fogdestam, 1983.
Sural flap; perforator flap from peroneal artery;...

Sural flap; perforator flap from peroneal artery; described by Donski and Fogdestam, 1983.

Perforator flap from the peroneal artery.Media file 13: Perforator flap from the peroneal artery.
Perforator flap from the peroneal artery.

Perforator flap from the peroneal artery.

Soleus muscle flap.Media file 14: Soleus muscle flap.
Soleus muscle flap.

Soleus muscle flap.

Dystrophic ulcer of the heel.Media file 15: Dystrophic ulcer of the heel.
Dystrophic ulcer of the heel.

Dystrophic ulcer of the heel.

First web space flap based on pedidial artery.Media file 16: First web space flap based on pedidial artery.
First web space flap based on pedidial artery.

First web space flap based on pedidial artery.

Flap from the first web space (4 X 6 cm).Media file 17: Flap from the first web space (4 X 6 cm).
Flap from the first web space (4 X 6 cm).

Flap from the first web space (4 X 6 cm).

The flap is transferred to reconstruct the poster...Media file 18: The flap is transferred to reconstruct the posterior heel defect; reconstruction of the donor area by split-thickness skin graft.
The flap is transferred to reconstruct the poster...

The flap is transferred to reconstruct the posterior heel defect; reconstruction of the donor area by split-thickness skin graft.

Long-term view of the donor area.Media file 19: Long-term view of the donor area.
Long-term view of the donor area.

Long-term view of the donor area.

Crush injury of the forefoot, plantar view.Media file 20: Crush injury of the forefoot, plantar view.
Crush injury of the forefoot, plantar view.

Crush injury of the forefoot, plantar view.

Crush injury of the forefoot, dorsal view.Media file 21: Crush injury of the forefoot, dorsal view.
Crush injury of the forefoot, dorsal view.

Crush injury of the forefoot, dorsal view.

Injury of the foot after debridement and reconstr...Media file 22: Injury of the foot after debridement and reconstruction by means of free latissimus dorsi muscle transfer with mesh skin graft, revascularized end to end on the posterior tibial artery and vein.
Injury of the foot after debridement and reconstr...

Injury of the foot after debridement and reconstruction by means of free latissimus dorsi muscle transfer with mesh skin graft, revascularized end to end on the posterior tibial artery and vein.

Long-term result, plantar view, after repair of i...Media file 23: Long-term result, plantar view, after repair of injury of the foot.
Long-term result, plantar view, after repair of i...

Long-term result, plantar view, after repair of injury of the foot.

Long-term result, dorsal view, after repair of in...Media file 24: Long-term result, dorsal view, after repair of injury of the foot.
Long-term result, dorsal view, after repair of in...

Long-term result, dorsal view, after repair of injury of the foot.

Avulsion of the foot sole, plantar view.Media file 25: Avulsion of the foot sole, plantar view.
Avulsion of the foot sole, plantar view.

Avulsion of the foot sole, plantar view.

Avulsion of the foot sole, side view.Media file 26: Avulsion of the foot sole, side view.
Avulsion of the foot sole, side view.

Avulsion of the foot sole, side view.

Planning of a large forearm flap.Media file 27: Planning of a large forearm flap.
Planning of a large forearm flap.

Planning of a large forearm flap.

Long-term result after reconstruction with free f...Media file 28: Long-term result after reconstruction with free forearm transfer revascularized side to end on the posterior tibial artery and vein.
Long-term result after reconstruction with free f...

Long-term result after reconstruction with free forearm transfer revascularized side to end on the posterior tibial artery and vein.

Side view after reconstruction of the sole with f...Media file 29: Side view after reconstruction of the sole with free forearm flap transfer, long-term result.
Side view after reconstruction of the sole with f...

Side view after reconstruction of the sole with free forearm flap transfer, long-term result.

More on Lower Extremity Reconstruction, Foot

Overview: Lower Extremity Reconstruction, Foot
Workup: Lower Extremity Reconstruction, Foot
Treatment: Lower Extremity Reconstruction, Foot
Follow-up: Lower Extremity Reconstruction, Foot
Multimedia: Lower Extremity Reconstruction, Foot
References

References

  1. McCraw JB. Selection of alternative local flaps in the leg and foot. Clin Plast Surg. Apr 1979;6(2):227-46. [Medline].

  2. Shanahan RE, Gingrass RP. Medial plantar sensory flap for coverage of heel defects. Plast Reconstr Surg. Sep 1979;64(3):295-8. [Medline].

  3. Grabb WC, Argenta LC. The lateral calcaneal artery skin flap (the lateral calcaneal artery, lesser saphenous vein, and sural nerve skin flap). Plast Reconstr Surg. Nov 1981;68(5):723-30. [Medline].

  4. McCraw JB, Furlow LT Jr. The dorsalis pedis arterialized flap. A clinical study. Plast Reconstr Surg. Feb 1975;55(2):177-85. [Medline].

  5. Masquelet AC, Romana MC. The medialis pedis flap: a new fasciocutaneous flap. Plast Reconstr Surg. May 1990;85(5):765-72. [Medline].

  6. Baudet J, Guimberteau JC, Nascimento E. Successful clinical transfer of two free thoraco-dorsal axillary flaps. Plast Reconstr Surg. Dec 1976;58(6):680-8. [Medline].

  7. Robinson DW. Microsurgical transfer of the dorsalis pedis neurovascular island flap. Br J Plast Surg. Jul 1976;29(3):209-13. [Medline].

  8. Dos Santos F. L'artere scapulaire posterieure. Paris; 1980.

  9. Acland RD, Schusterman M, Godina M, et al. The saphenous neurovascular free flap. Plast Reconstr Surg. Jun 1981;67(6):763-74. [Medline].

  10. Song R, Song Y, Yu Y. The upper arm free flap. Symposium on one stage reconstruction. In: Song R, ed. Clinics in Plastic Surgery. Vol 9. New York: WB Saunders; 1982:27-36.

  11. Taylor GI, Miller GD, Ham FJ. The free vascularized bone graft. A clinical extension of microvascular techniques. Plast Reconstr Surg. May 1975;55(5):533-44. [Medline].

  12. Taylor GI. The current status of free vascularized bone grafts. Clin Plast Surg. Jan 1983;10(1):185-209. [Medline].

  13. Hidalgo DA, Shaw WW. Reconstruction of foot injuries. Clin Plast Surg. Oct 1986;13(4):663-80. [Medline].

  14. Donski PK, Fogdestam I. Distally based fasciocutaneous flap from the sural region: a preliminary report. Scand J Plast Surg. 1983;17:191.

  15. Pakiam AI. The reversed dermis flap. Br J Plast Surg. Apr 1978;31(2):131-5. [Medline].

  16. Nassif TM, Vidal L, Bovet JL, et al. The parascapular flap: a new cutaneous microsurgical free flap. Plast Reconstr Surg. Apr 1982;69(4):591-600. [Medline].

  17. Chang Di Sheng. Radial artery fascial flap. Presented at: Annual Meeting of the American Society of Plastic Reconstructive Surgery. Honolulu, HI; October 1982.

  18. Masuoka T, Nomura S, Yoshimura K, et al. Deep inferior epigastric perforator flap for foot reconstruction using an external pedicle. J Reconstr Microsurg. May 2005;21(4):231-4. [Medline].

  19. Mathes SJ, Nahai F. Clinical application for muscle and musculocutaneous flaps. St Louis: Mosby; 1982.

  20. Morrison WA, Crabb DM, O'Brien BM, et al. The instep of the foot as a fasciocutaneous island and as a free flap for heel defects. Plast Reconstr Surg. Jul 1983;72(1):56-65. [Medline].

  21. Nerlich AG, Zink A, Szeimies U, et al. Ancient Egyptian prosthesis of the big toe. Lancet. Dec 23-30 2000;356(9248):2176-9. [Medline].

  22. O'Brien B McC, Morrison WA. Reconstructive Microsurgery. Churchill Livingstone; 1987.

  23. O'Brien BM, MacLeod AM, Hayhurst JW, et al. Successful transfer of a large island flap from the groin to the foot by microvascular anastomoses. Plast Reconstr Surg. Sep 1973;52(3):271-8. [Medline].

  24. Organek AJ, Klebuc MJ, Zuker RM. Indications and outcomes of free tissue transfer to the lower extremity in children: review. J Reconstr Microsurg. Apr 2006;22(3):173-81. [Medline].

  25. Strauch B, Vasconez LO, Hall-Finlay EJ. Grabb's Encyclopedia of Flaps. Vol 3. 2nd ed. Philadelphia: Lippincott-Raven; 1998.

Further Reading

Keywords

lower extremity reconstruction, foot surgery, foot pressure, foot reconstruction, foot surgery, weightbearing, foot defects, foot ulcers, padding properties, body weight, foot flap, saphenous nerve, sciatic nerve, ankle, sole, dorsum, toes, extensor brevis digitorum, extensor hallucis, metatarsal bones, anterior tibial pedicle, posterior tibial pedicle, peroneal pedicle, internal plantar nerve, posterior tibial nerve

Contributor Information and Disclosures

Author

Fabio Santanelli, MD, PhD, Associate Professor of Plastic Surgery, University of Rome; Chief of Unita Operativa Dipartimentale di Chirurgia Plastica, Azienda Ospedaliera, Sant'Andrea, Rome
Fabio Santanelli, MD, PhD is a member of the following medical societies: American Society of Plastic and Reconstructive Surgery, European Association of Plastic Surgeons, and International Confederation for Plastic and Reconstructive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Francesca Romana Grippaudo, MD, Assistant Professor, Unit of Plastic Surgery, 2nd Medical Faculty, Sapienza University of Rome, Italy
Francesca Romana Grippaudo, MD is a member of the following medical societies: International Confederation for Plastic and Reconstructive Surgery
Disclosure: Nothing to disclose.

Stefania Tenna, MD, Consulting Staff, Department of Plastic Surgery, University of Rome Policlinico Umberto I, Italy
Disclosure: Nothing to disclose.

Guido Paolini, MD, Plastic Surgery Unit, Assistant Professor of Plastic Surgery, Sant'Andrea Hospital- University of Rome La Sapienza -Italy
Disclosure: Nothing to disclose.

Emanuele Cigna, MD, Consultant Plastic Surgeon, Department of Plastic and Reconstructive Surgery, University of Rome La Sapienza, Italy
Disclosure: Nothing to disclose.

Medical Editor

Christian Paletta, MD, FACS, Professor, Division Chief and Program Director, Department of Plastic and Reconstructive Surgery, St Louis University School of Medicine
Christian Paletta, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Association of Plastic Surgeons, American Burn Association, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, and Missouri State Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

B Sekhar Chandrasekhar, MD, Associate Professor, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Southern California
B Sekhar Chandrasekhar, MD is a member of the following medical societies: American Association of Plastic Surgeons, American College of Surgeons, American Society for Reconstructive Microsurgery, and California Medical Association
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

 
 
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