Abstract
A Sixteen-year-old male had a road traffic accident resulting in crush and loss of lateral two metatarsals of the left foot. The Lateral plantar arch was reconstructed with a vascularized fibula osteocutaneous flap. Flap survived and partial weight-bearing was started by 3 months and full weight-bearing was started 6-months post-surgery. At a 16-month follow-up patient had a normal gait and integrity of the lateral plantar arch was maintained. Vascularized fibula osteocutaneous flap is an excellent option for one-stage reconstruction of the lateral arch of the foot and gives satisfactory results in terms of functions of foot and in avoiding long-term morbidity.
Highlights
Plantar arches of the foot are a very essential part of the normal gait mechanism
Foot and leg are the most common parts to be injured in a road traffic accident (RTA)
We present a case with a lateral plantar arch defect of foot managed with bony and soft tissue reconstruction
Summary
Plantar arches of the foot are a very essential part of the normal gait mechanism. Its dynamicity can be appreciated in dancers and artistic gymnasts. The lateral metatarsals (4th and 5th) are an integral part of the three-point support and balancing of the foot, its reconstruction is very essential for a near-normal gait. We present a case with a lateral plantar arch defect of foot managed with bony and soft tissue reconstruction. With the improvement of wound bed, 15 days following injury (Figure 1d-e), lateral plantar arch reconstruction by Vascularized fibula osteocutaneous flap (VFOC) was planned and a pre-op Doppler scan was done to locate the perforator vessel providing the skin. A dynamic pressure sensing pedobarogram showed no adverse pressure points (Figure 4) His Foot and Ankle Ability Measure – Activities of Daily Living scale (FAAMADL) score was 82.14% and he rated his overall current level of function to be 80% considering his pre-injury function as 100%
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