Our experience of the sural flap with distal pedicle in the repair of foot plantar and heel of foot lesions

PURPOSEThe sural flap has often been used to cover the weight-bearing and non-weight-bearing areas of the foot and ankle. This study reports our experience in the coverage of these defects in the foot in weight-bearing areas. PATIENTS AND METHODThis is a retrospective and descriptive study of 70 months. This study includes 16 patients presenting a loss of plantar substance and/or heel of the foot covered by a sural flap with a distal pedicle. The sampling technique described by Masquelet served as our reference. An increase in the length of the pedicle of at least two centimeters during the dissection made it possible to avoid any stretching or compression for the most distal lesions. RESULTSThe average age was 35 years with a sex ratio of three in favor of men. Traumatic lesions predominated (n=10) with an average area of lesions of 68.8cm2. The average partial and total support times were 1.8 and 3.6 months respectively. We noted one case of flap necrosis. The natural evolution of the flap took place in three progressive stages: regeneration, keratinization and squamous metaplasia. Normal bipodal support and stable gait without footwear anomaly were noted in 15 cases. CONCLUSIONThe distal pedicle sural flap technique is accessible. Its reliability makes it an ideal choice for distal loss of substance to the leg and foot.