[Coverage of heel tissue loss by two pediculated flaps in a single procedure].
We report the case of a traffic accident victim who suffered major tissue loss of the heal. We used two pediculated flaps to close the gap in a single procedure. The remaining tissue presented zones of necrosis from the plantar aspect to the posterior half of the calcaneum, up to the insertion of the calcaneus tendon, extending 5 cm on the posterior aspect of the heal. We decided to combine a medial plantar flap with a lateral supramalleolar flap. The thick medial plantar flap allowed cover of the calcaneum and sensitivity. The calcaneus tendon was covered with the lateral supramalleolar flap. The thickness of the flap was adapted to match the tissue defect. At six months, the patient had recovered walking function with satisfactory weight bearing on the heal. Flap sensitivity was satisfactory with no slipping phenomenon.
Cognet
J-M
JM
Département d'Orthopédie et de Traumatologie, Hôpital de Hautepierre, avenue Molière, Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg. Jean-Michel.COGNET@chru-strasbourg.fr
Stussi
J-D
JD
Dujardin
C
C
Prevost
P
P
Simon
P
P
D000063:Accidents, Traffic; D000328:Adult; D018409:Foot Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006365:Heel / Q000293:injuries*; D006801:Humans; D008297:Male; D009336:Necrosis; D018579:Patient Selection; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D016138:Walking; D016474:Weight-Bearing