Abstract
Division of the lateral plantar artery does not jeopardize the foot circulation because of anastomosis of the lateral plantar artery with the dorsalis pedis artery at the first intermetatarsal space. However, care should be taken with patients with peripheral artery occlusive disease and the flow of dorsalis pedis artery should be confirmed before surgery. Given the advantages of sizable vessel, easy dissection, and proximity to the defect, we believe that the lateral plantar artery might be a valuable option as recipient vessel for lateral plantar forefoot reconstruction.
Highlights
Reconstruction of the plantar forefoot area remains a challenging problem due to the limited alternatives
We report two cases with lateral plantar forefoot defects where the lateral plantar artery was used as recipient vessel for free flap reconstruction
In the case 1, the defect was a candidate for a reverse medial plantar flap, we were concerned about the uncertainty of the venous drainage and felt safer to perform free flap reconstruction
Summary
Reconstruction of the plantar forefoot area remains a challenging problem due to the limited alternatives. The lateral plantar artery, one of the dominant vessels contributing plantar foot circulation, is rarely reported to be used as recipient vessel for free flap reconstruction. We report two cases with lateral plantar forefoot defects where the lateral plantar artery was used as recipient vessel for free flap reconstruction. The case reports describe the relevant surgical anatomy and discuss the role in the plantar forefoot reconstruction It travels downward obliquely between the flexor digitorum brevis muscle and the quadratus plantae after bifurcation with medial plantar artery in the second plantar layer. After dividing the plantar fascia and separating the junction between the flexor digitorum brevis muscle and the abductor digiti minimi, the lateral plantar artery along with one accompanying vein was dissected out. The flap was transferred and microvascular anastomosis was performed
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