Laboratory Studies
See the list below:
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Obtain a complete blood count (CBC).
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Obtain prothrombin time and activated partial thromboplastin time to check for coagulopathy.
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Check for blood sugar if suggested by anamnesis.
Imaging Studies
See the list below:
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Obtain leg and/or foot radiographs for patients with trauma or for osteocutaneous free transfers.
Radiograph illustrating the dispositions of the shafts in the ankle joint and the heel.
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Obtain a chest radiograph if indicated by examination findings or the patient's history.
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Obtain leucocyte lymphoscintigraphy in patients with osteomyelitis.
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Obtain baropodometric evaluation or gait analysis to identify eventual bone functional loss and to plan a repair of the arches.
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Nuclear magnetic resonance especially is indicated to study ligaments and joints but also to evaluate the soft tissue damage.
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.
Other Tests
Perform Doppler, echo Doppler, or angiography to assess the vascular pattern of the foot and leg and identify perforators as a possible source of pedicled, propeller, or free flaps.
Perform an Allen test in patients with radial free flaps.
Obtain an ECG in elderly individuals or as per operating room guidelines.
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Different evolutions of the foot in primates.
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View of the 2 arches of the foot.
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Lateral and medial views of the vectors.
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Xeroradiography shows the dispositions of the shafts and the 2 arches theory.
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Radiograph illustrating the dispositions of the shafts in the ankle joint and the heel.
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Computerized baropodometry of the foot. Views of the different pressure levels.
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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.
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Medial plantar flap, instep flap (O'Brien and Shanahan, 1979).
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Dorsalis pedis flap, described by McCraw and Furlow (1975).
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Medialis pedis flap described by Masquelet (1990).
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Lateral calcaneal artery skin flap, described by Grabb and Argenta (1981).
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Sural flap; perforator flap from peroneal artery; described by Donski and Fogdestam, 1983.
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Perforator flap from the peroneal artery.
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Soleus muscle flap.
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Dystrophic ulcer of the heel.
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First web space flap based on pedidial artery.
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Flap from the first web space (4 X 6 cm).
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The flap is transferred to reconstruct the posterior heel defect; reconstruction of the donor area by split-thickness skin graft.
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Long-term view of the donor area.
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Crush injury of the forefoot, plantar view.
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Crush injury of the forefoot, dorsal view.
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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.
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Long-term result, plantar view, after repair of injury of the foot.
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Long-term result, dorsal view, after repair of injury of the foot.
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Avulsion of the foot sole, plantar view.
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Avulsion of the foot sole, side view.
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Planning of a large forearm flap.
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Long-term result after reconstruction with free forearm transfer revascularized side to end on the posterior tibial artery and vein.
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Side view after reconstruction of the sole with free forearm flap transfer, long-term result.
Tables
Dimension |
Extension |
Localization |
Type of Flap |
< 3 cm2 |
Soft tissue |
Weightbearing areas |
Local flap |
< 3 cm2 |
Soft tissue |
Nonweightbearing areas |
Skin grafts |
>3 cm2 |
Soft tissue |
Weightbearing areas |
Pedicled perforator or propeller flap, and/or free flap (free fasciocutaneous, musculocutaneous flaps, muscle free flap plus skin graft) |
>3 cm2 |
Soft tissue and bone loss |
Weightbearing areas |
Free osteocutaneous flap |
