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The extended medial plantar artery (EMPA) free flap for plantar foot defects

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Abstract

The medial plantar artery (MPA) flap was first introduced by Mir y Mir in 1954 and used to reconstruct a heel defect. The sole of the foot is designed to bear body weight and absorb the shocks of a bipedal gait. The properties of the plantar skin and deeper tissues are therefore highly specialised, and if normal function is to be restored, it is essential to replace “like with like” which is a fundamental principle of reconstructive surgery.

The aim of this article is to introduce the concept of an extended medial plantar artery (EMPA) free flap for plantar foot defects. The advantage of the extended version of the MPA flap in the presented cases is the harvest of a larger bulk of tissue and thus the possibility of covering larger defects in the weight-bearing area of the foot.

Level of Evidence: Level V, therapeutic study.

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References

  1. Mir Y, Mir L (1954) Functional graft of the heel. Plast Reconst Surg 14:444–450

    Article  Google Scholar 

  2. Baker GL, Newton ED, Franklin JD (1990) Fasciocutaneous island flap based on the medial plantar artery: clinical applications for leg, ankle, and forefoot. Plast Reconstr Surg 85:47–58

    Article  CAS  PubMed  Google Scholar 

  3. Masquelet AC, Romana MC (1990) The medialis pedis flap: a new fasciocutaneous flap. Plast Reconstr Surg 85:765–772

    Article  CAS  PubMed  Google Scholar 

  4. Morrison WA, Crabb DM, O'Brien BM et al (1983) The instep of the foot as a fasciocutaneous island and as a free flap for heel defects. Plast Reconstr Surg 72:56–65

    Article  CAS  PubMed  Google Scholar 

  5. Gir P, Cheng A, Oni G, Mojallal A, Saint-Cyr M (2012) Pedicled-perforator (propeller) flaps in lower extremity defects: a systematic review. J Reconstr Microsurg 28:595e601

    Article  Google Scholar 

  6. Koshima I, Narushima M, Mihara et al (2007) Island medial plantar artery perforator flap for reconstruction of plantar defects. Ann Plast Surg 59:558–562

  7. Attinger CE, Evans KK, Bulan E, Blume P, Cooper P (2006) Angiosomes of the foot and ankle and clinical implications for limb salvage: reconstruction, incisions, and revascularization. Plast Reconstr Surg 117(7 suppl):261Se293S

    Google Scholar 

  8. Koshima I, Urushibara K, Inagawa K, Hamasaki T, Moriguchi T (2001) Free medial plantar perforator flaps for the resurfacing of finger and foot defects. Plast Reconstr Surg 107:1753–1758

    Article  CAS  PubMed  Google Scholar 

  9. AMR A, Dalley AF (2009) Grant’s atlas of anatomy. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, p 864

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Klinikum Wels, Grieskirchen, Austria

    Tomas Kempný

  2. Department of Burns and Reconstructive Surgery, University Hospital Brno, Brno, Czech Republic

    Tomas Kempný, Martin Knoz & Bretislav Lipový

  3. Medical Faculty, Masaryk University Brno, Brno, Czech Republic

    Martin Knoz & Bretislav Lipový

  4. Department of Plastic and Aesthetic Surgery, St. Anne’s University Hospital Brno, Brno, Czech Republic

    Martin Knoz

Authors
  1. Tomas Kempný
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  2. Martin Knoz
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  3. Bretislav Lipový
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Corresponding author

Correspondence to Martin Knoz.

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Conflict of interest

Dr. Kemný T., Dr. Knoz M. and Dr. Lipový B. declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this kind of retrospective study formal consent form a local ethics committee is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kempný, T., Knoz, M. & Lipový, B. The extended medial plantar artery (EMPA) free flap for plantar foot defects. Eur J Plast Surg 40, 563–568 (2017). https://doi.org/10.1007/s00238-017-1324-9

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  • DOI: https://doi.org/10.1007/s00238-017-1324-9

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