[Therapeutic options in treatment of heel defects. Presentation of an algorithm for therapeutic strategy].
BACKGROUND
The treatment of soft tissue defects of the foot and ankle region remains a challenge, because special anatomical and physiological properties have to be considered.


METHODS
The data of 52 patients, who were treated between 1994 and 1998, were analyzed. 48% were posttraumatic defects and were located in the weight bearing zone in 37%.


RESULTS
Fifty-nine procedures were used, including skin transplantation in 16 patients, local flaps in 3 cases, regional flaps in 14 cases, and microvascular procedures in 17 cases. Amputation was required in 4 patients. The overall success rate was 92%. Complications occurred in 18 patients.


CONCLUSIONS
Using these data and evaluation of the actual literature lead to the development of an algorithm for the treatment of defects in this area. The modern armamentarium of plastic surgery offers the possible different treatment modalities.
Menke
H
H
Abteilung für Verbrennungen, Plastische- und Handchirurgie, Universität Heidelberg.
Baumeister
S
S
Erdmann
D
D
Sauerbier
M
M
Germann
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000671:Amputation, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000209:etiology / Q000601:surgery*; D006365:Heel / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013524:Surgical Flaps; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology; D014946:Wound Infection / Q000209:etiology / Q000601:surgery*