Reconstruction of Dorsum and Amputated Foot Stump

Basic Principles

The dorsum of the foot has a large number of tendons, and is a difficult place for a skin graft to take. The method of creating granulation tissue using artificial dermis and then conducting a skin graft is available as an option, but fixing the foot in place for long periods decreases the range of movement of the ankle and can induce contracture such as equinus foot.

For the reconstruction of an amputation stump using a free flap, a comparatively thin skin flap is chosen. The dorsal artery of the foot is close to the reconstruction position and muscle spasms tend to occur, so anastomosis (if possible end-to-side) to the posterior tibial artery is the preferred option.

The difficulty level of each surgical procedure is shown subsequent to the procedure title (e.g., Level of Difficulty: 2). The levels range from 1 to 5, with level 1 indicating a preliminary level and level 5 indicating a very advanced level.