Techniques for covering soft tissue defects resulting from plantar ulcers in leprosy: Part III - use of plantar skin or musculocutaneous flaps and anterior leg flap

Anatomical studies suggest that five types of plantar flaps namely, the lateral and medial plantar flaps, the Abductor hallucis, the Flexor digitorum brevis, and the Abductor digiti minimi myocutaneous flaps, can be incised from the central section of the sole. The advantages of a plantar flap are recognizable neurovascular bundles of the sole, wide calibre of constantly located blood vessels, identical histological structure of the donor and the recipient sites, hidden donnor site and absence of functional deficit. We have used the palntar flaps in seven cases. There has been no recurrence of ulceration in any of them during the follow up period of 12 to 108 month. An anterior leg flap based on the cutaneous branches of the anterior tibial artery, with firmly anchored vessels, a long pedicle with wide vessels may used not only as a free flap graft for reconstruction of moderate degree distant defects but also as a retrograde island flap graft for the reconstruction of adjacent tibial artery in five cases of plantar ulceration with satisfactoryresults. there was no recurrence of ulceration during the follow up period of 48 to 72 months