Skip to main content

Soft Tissue Management in the Foot and Ankle

  • Chapter
  • First Online:
  • 2459 Accesses

Abstract

Successful soft tissue reconstruction of the foot and ankle is challenging and often needs an interdisciplinary approach, especially when composite defects are present. This chapter provides a coherent concept to treat cases of severe skin and soft tissue damage of the foot and ankle. A functional and anatomical subdivision of the foot and ankle region is proposed depending on its pressure distribution, soft tissue quality, zones of shear and the structural anatomy. A treatment algorithm, highlighted by two clinical cases, is presented considering common and well established local, regional and micro-surgical reconstructive options to restore maximum sensibility, motor function and aesthetics.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Godina M. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg. 1986;78:285–92.

    Article  CAS  PubMed  Google Scholar 

  2. Ullman Y, Fodor L, Ramon Y, et al. The revised reconstructive ladder and its applications for high-energy injuries to the extremities. Ann Plast Surg. 2006;56:401–5.

    Article  Google Scholar 

  3. Hidalgo DA, Shaw WW. Reconstruction of foot injuries. Clin Plast Surg. 1986;13:663–80.

    CAS  PubMed  Google Scholar 

  4. Haug MD, Valderrabano V, Rieger UM, Pierer G, Schaefer DJ. Anatomically and biomechanically based treatment algorithm for foot and ankle soft tissue reconstruction. Handchir Mikrochir Plast Chir. 2008;40:377–85.

    Article  CAS  PubMed  Google Scholar 

  5. Medina ND, Kovach III SJ, Levin LS. An evidence-based approach to lower extremity acute trauma. Plast Reconstr Surg. 2011;127:926–34.

    Article  CAS  PubMed  Google Scholar 

  6. Hallock GG. Local fasciocutaneous flap skin coverage for the dorsal foot and ankle. Foot Ankle. 1991;11:275–81.

    Article  Google Scholar 

  7. Hallock GG. Distally based flaps for skin coverage of the foot and ankle. Foot Ankle Int. 1996;17:343–8.

    Article  CAS  PubMed  Google Scholar 

  8. Nakajima H, Imanishi N, Fukuzumi S, et al. Accompanying arteries of the cutaneous veins and cutaneous nerves in the extremities: anatomical study and a concept of the venoadipofascial and/or neuroadipofascial pedicled fasciocutaneous flap. Plast Reconstr Surg. 1998;102:779–91.

    Article  CAS  PubMed  Google Scholar 

  9. Lu L, Liu A, Zhu L, et al. Cross-leg flaps: our preferred alternative to free flaps in the treatment of complex traumatic lower extremity wounds. J Am Coll Surg. 2013;217:461–71.

    Article  PubMed  Google Scholar 

  10. Teo LC. The propeller flap concept. Clin Plast Surg. 2010;37:615–26.

    Article  PubMed  Google Scholar 

  11. Yazar S, Lin CH, Wei FC. One-stage reconstruction of composite bone and soft-tissue defects. Plast Reconstr Surg. 2004;114:1457–66.

    Article  PubMed  Google Scholar 

  12. Milanov NO, Adamyan RT. Functional results of microsurgical reconstruction of plantar defects. Ann Plast Surg. 1994;32:52.

    Article  CAS  PubMed  Google Scholar 

  13. Hong JP, et al. Sole reconstruction using AL perforator flaps. Plast Reconstr Surg. 2007;119:186.

    Article  CAS  PubMed  Google Scholar 

  14. Santanelli F, Tenna S, Pace A, et al. Free flap reconstruction of the sole of the foot with or without sensory nerve coaptation. Plast Reconstr Surg. 2002;109:2314–22.

    Article  PubMed  Google Scholar 

  15. Scheufler O, Kalbermatten DF, Pierer G. Instep free flap for plantar soft tissue reconstruction: indications and options. Microsurgery. 2007;27(3):174–80.

    Article  PubMed  Google Scholar 

  16. Peek A, Giessler G. Free composite heel reconstruction. Ann Plast Surg. 2006;56(6):628–34.

    Article  CAS  PubMed  Google Scholar 

  17. Durham JW, et al. Outcome after free flap reconstruction of the heel. Foot Ankle Int. 1994;15:250.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rik Osinga .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Osinga, R., Gohritz, A., Haug, M.D., Schaefer, D.J. (2016). Soft Tissue Management in the Foot and Ankle. In: Valderrabano, V., Easley, M. (eds) Foot and Ankle Sports Orthopaedics. Springer, Cham. https://doi.org/10.1007/978-3-319-15735-1_43

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-15735-1_43

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15734-4

  • Online ISBN: 978-3-319-15735-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics