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Alternatives in soft tissue reconstruction of the ankle and foot.

Reconstruction of soft tissue defects of the ankle and foot still presents a challenge. This is related to both the lack of large soft tissue flaps in this part of the body suitable for transfer to adjacent injured areas and to of the unique characteristics of the soft tissues of the sole of the foot. Microsurgery has solved some of these problems with the transfer of soft tissue from more distal areas. Several small arterialized and sometimes innervated flaps from the intrinsic tissues of the foot are also available for reconstruction of defects of limited size. The present report assesses 49 flaps, 15 local and 34 microsurgical transfers which were performed in 46 patients. The results suggest that there are several effective alternatives for coverage of soft tissue defects of the ankle and foot.