12.  Discuss foot flap options for malleolus, heel, non-weight bearing mid-sole, distal plantar surface and dorsum.  (Clinics in Plastic Surgery, October 1996)

Answer:
The flap available for coverage in the foot include: the abductor digiti minimi flap, the abductor hallucis flap, the dorsalis pedis flap, the flexor digitorum brevis flap, the lateral plantar artery flap, the medial plantar artery flap.  The abductor digiti minimi flap can be used to cover the lateral ankle, or advanced in a V-Y fashion to the distal foot.  Similarly, on the medial aspect of the foot, the abductor hallucis flap can be used to cover the medial ankle, or advanced distally over the plantar surface of the foot. The dorsalis pedis flap can be swung medially to cover the medial ankle, or the reverse flap can be rotated distally to cover the distal dorsal surface. The flexor digitorum brevis flap, along the proximal plantar surface can be swung posteriorly to cover the heel, or the reverse flap can be advanced distally in a V-Y fashion to cover the distal plantar surface. The lateral plantar artery flap, which involves the proximal one-third of the sole, including the heel, and the lateral side of the sole, and the non-weight bearing central part of the sole, can be rotated to cover defects of the heel, or again, advanced distally in a V-Y fashion to cover plantar surface defects. The medial plantar artery is identical, only located on the medial aspect of the plantar surface at the instep.
 

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