Heel reconstruction in Plastic Surgery

Q) For a 3 X 4 cm defect on weight bearing heel, the ideal flap would be 

a) Gracilis and skin

b) Radial forearm

c) Dorsalis Pedis

d) Medial Plantar Island flap

Answer d

Sensate pedicled medial plantar island

This area of the heel is a sensitive area and would be under tremendous gravitational and shearing force. It will require a resilient flap in the form of choice d. This island flap is sensate, hairless and tough.

All other are muscle flaps which do not provide enough strength and are unstable. They also do not have a sensory supply.