Medial Plantar Artery (Instep Flap) Flap

In Brief Provision of sensation to the weightbearing surface of the heel is very vital in the sensate foot. Hence, resurfacing the weightbearing surface of the heel requires provision of stable skin cover and sensation.We have many options to fulfill the above requirements. Skin of the instep area can be raised as an island fasciocutaneous flap based on medial plantar vessels, with the branch of medial plantar nerve supplying the instep skin to provide the sensation. Medial plantar artery (instep) flap provides similar tissue with sensation and reaches the posteriormost part of the weightbearing surface of the heel with ease. We present in this article the relevant surgical anatomy, technique, and the clinical experience of 12 patients. Twelve plantar heel defects were reconstructed with island medial plantar artery (instep) flaps incorporating the plantar aponeurosis and branches of the medial plantar nerve. All patients regained protective sensation and a normal gait with standard footwear.