Journal of Foot and Ankle Surgery (Asia Pacific)

Register      Login

VOLUME 5 , ISSUE 2 ( December, 2018 ) > List of Articles

ORIGINAL ARTICLE

Reusable Frame for Pedicle Protection in Heel and Ankle Defects

Sonal T Lal, Chandanpreet K Kahlon, Deepak J Bhatti

Keywords : Heel defects, Metatarsophalangeal joints, Pedicle protection, Reusable frame splint

Citation Information : Lal ST, Kahlon CK, Bhatti DJ. Reusable Frame for Pedicle Protection in Heel and Ankle Defects. J Foot Ankle Surg Asia-Pacific 2018; 5 (2):56-58.

DOI: 10.5005/jp-journals-10040-1090

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Introduction: It has always been a challenging task for the reconstructive surgeons to resurface the lost skin and soft tissue over the heel. This is done by use of skin grafts, local flap or microvascular free flap (MFF). The postoperative care and splintage of these limbs is a difficult task, and often the success or failure of the flap will depend on proper postoperative splintage and positioning of the operated limb. A simple and reusable frame is being described for pedicle protection in flap surgery for posterior heel and ankle wounds. Aims and objective: To devise a reusable frame for pedicle protection in heel and ankle defects. Materials and methods: A reusable frame splint designed by holding up the foot against gravity at a narrower circumference of forefoot just proximal to the wider circumference of the foot at the metatar sophalangeal joint (MTP) level. This frame was used in the early postoperative period for positioning the lower limb in patients undergoing surgery for coverage of posterior heel defects. Result: A total of 14 patients underwent wound coverage of post heel defect over a period of 3 years. Out of these 14 patients, nine had reverse sural artery pedicle flap, three had split-thickness skin grafting and remaining two had MFF done. In all the cases, a specially designed frame was used for pedicle protection. One patient had developed erosion and blistering, which healed subsequently. Conclusion: This innovation in the splint helps in providing adequate elevation of limb and protection of pedicle of local or MFF used for coverage of heel and ankle defects.


PDF Share
  1. Upadhyaya DN, Khanna V, Pandey A, Puri A, Kohli R. The Lucknow splint. Indian J Plast Surg 2012;45:587-588.
  2. Kamath JB. A simple method for pedicle protection in flap surgery for posterior heel defects. Indian J Plast Surg 2003;36:104-105.
  3. Gregory A, Buford MD, Mark A. A novel method for Lower- Extremity Immobilization after free flap reconstruction of posterior heel defects. Plast Reconstr Surg 2003;111:821.
  4. Ninan S, Manigandan C, Gupta AK. Post operative care of flaps using the Bohler braun frame. An innovation. Plast Reconstr Surg 2005;115:676-677.
  5. Bhaskara KG, Kale SM. Use of Thomas splint in salvaging free flaps of lower limb in violent postoperative patients. Indian J Plast Surg 2009;42:271-272.
  6. Ellur S. Modified pillow splint. Indian J Plast Surg 2011; 44:529-530.
  7. Venkatramani H, Jain DA, Sabapathy SR. A useful modification of plaster backslab to off-load pressure from reconstructions of the heel and elbow. Indian J Plast Surg 2012;45: 588-589.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.