Hand Reconstruction Using Medialis Pedis and Medial Plantar Chimeric Free Flap

Su Bin Do; Jae Hyun Kim; Chul Hoon Chung

doi:10.12790/jkssh.2017.22.1.57

Journal List > J Korean Soc Surg Hand > v.22(1) > 1106579

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Do, Kim, and Chung: Hand Reconstruction Using Medialis Pedis and Medial Plantar Chimeric Free Flap

Case Report

Journal of the Korean Society for Surgery of the Hand 2017; 22(1): 57-62.

Published online: 30 March 2017

DOI: https://doi.org/10.12790/jkssh.2017.22.1.57

Hand Reconstruction Using Medialis Pedis and Medial Plantar Chimeric Free Flap

Su Bin Do, Jae Hyun Kim, Chul Hoon Chung

Department of Plastic & Reconstructive Surgery, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.

Correspondence to: Jae Hyun Kim. Department of Plastic & Reconstructive Surgery, Hallym University Hangang Sacred Heart Hospital, 12 Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul 07247, Korea. TEL: +82-2-2639-5700, FAX: +82-2-2633-7571, jaykay0219@naver.com

Received 10 October 2016 Revised 26 December 2016 Accepted 15 January 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

It is not easy to decide whether covering soft tissue defect occurred in multiple adjacent fingers with a single, large flap and later secondary division of fingers or cover each digits independently in hand reconstruction. The authors reconstructed soft tissue defect of left second and third finger with medial plantar artery based medialis pedis and medial plantar chimeric free flap and it enabled early rehabilitation without secondary surgery to divide each fingers and get satisfactory result.

Keywords: Medialis pedis, Medial plantar, Chimeric

Figures and Tables

Fig. 1

(A) Preoperative photograph shows incomplete amputation of left index, long, ring finger. (B) Soft tissue defect of left index and long finger with exposed flexor tendon after primary surgery.

Fig. 2

Intraoperative photograph. (A) Marking of medial plantar artery and its branches using Doppler sonography. (B) Elevated medialis pedis and medial plantar chimeric free flap. (C) Covered soft tissue defect of left index and long finger by medialis pedis and medial plantar chimeric free flap.

Fig. 3

(A) Postoperative photograph before debulking. (B) After the debulking operation.

Fig. 4

Postoperative photograph shows range of motion.

References

1. Okada M, Saito H, Kazuki K, Nakamura H. Combined medialis pedis and medial plantar fasciocutaneous flaps for coverage of soft tissue defects of multiple adjacent fingers. Microsurgery. 2014; 34:454–458.

2. Tsai FC, Cheng MH, Chen HC, Wei FC. Microsurgical medialis pedis flaps for reconstruction of soft-tissue defects in the hand. Ann Plast Surg. 2002; 48:41–47.

3. Chai YM, Wang CY, Wen G, Zeng BF, Cai PH, Han P. Combined medialis pedis and medial plantar fasciocutaneous flaps based on the medial plantar pedicle for reconstruction of complex soft tissue defects in the hand. Microsurgery. 2011; 31:45–50.

4. Kim SW, Min WK, Hong JP, Chung YK. Combined medial plantar and medialis pedis chimeric flap for sole reconstruction. J Korean Soc Microsurg. 2000; 9:110–113.

5. Rodriguez-Vegas M. Medialis pedis flap in the reconstruction of palmar skin defects of the digits: clarifying the anatomy of the medial plantar artery. Ann Plast Surg. 2014; 72:542–552.

6. Yoon ES, Kim DW, Chun D, et al. An anatomic study and clinical application of medial pedis flap in Asians. Ann Plast Surg. 2007; 58:517–522.

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