The Microvascular Carpal Foot Pad Flap: Results in Three Clinical Cases

Abstract

SummaryFour microvascular carpal foot pad transfers were performed on three dogs for reconstruction of weight bearing surfaces. All of the dogs had suffered severe trauma to the major weight bearing foot pads of at least one foot due to: burn injury (one dog), ischaemic injury (one dog) or sharp trauma (one dog). The vascular anatomy of the carpal foot pad flap was consistent in all of the dogs. The arterial pedicle arose from the caudal interosseous artery and the venous effluent drained via the cephalic vein. All of the flaps survived transfer. Post-operative care included heavily padded bandages and daily visual assessment of flap viability. All of the flaps developed partial wound dehiscence along their distal borders, presumably due to incisional stresses from weight bearing. The flaps were surgically repositioned as necessary in order to maintain a central weight bearing position. Ultimately, all of the flaps healed and hypertrophied to accomodate weight bearing stresses. In all dogs functional results were good.Foot pads are highly specialized to withstand the hostile environments into which they are placed. Reconstruction of weight bearing surface following loss of foot pads, therefore, is difficult. Microvascular free transfer of foot pads allows the reconstruction of such deficits with tissue that is, anatomically, most appropriately suited to adopt the function of weight bearing. Microvascular free transfer of the carpal foot pad flap for foot reconstruction is demonstrated in three clinical cases.