Complete Heel Pad Avulsion: Repair with Nylon Suture Anchors, IV Tubing Pledgets, and Anterolateral Thigh Flap

We report a 65-year-old man with complete heel pad avulsion and large full-thickness skin defect on the anterolateral foot and ankle. The heel pad was reattached to the calcaneus using two 1-0 nylon sutures with intravenous tubing pledgets. The defect was covered with an anterolateral thigh (ALT) flap. At 13 months postoperatively, the heel pad remained securely attached, and the ALT flap was healthy. The patient could fully weight bear and perform single-leg stance and calf raises without pain. This novel approach to repairing complete heel pad avulsions has not been previously described. It offers a simple, cost-effective option, particularly suited for resource-limited settings.