Reconstruction of soft tissue defects of the sole is a challenging problem. Bulky flaps interfering with footwear is common sequelae. Multiple operations are often required to achieve a functional foot. We describe the case of a motorcyclist who sustained degloving injury to his left sole when he was hit by a car. The defect was resurfaced by a free latissimus dorsi flap and a meshed skin graft. After a year partial flap thinning was done, as it was bulky. Though he was grateful for the reconstruction he still could not wear a shoe, the gait was affected and he felt the flap was wobbly. 8 months later he underwent a further flap thinning. At this stage lack of adherence of the flap to the undersurface was noted and a flap hitch
- Horlock N.
- Grobbelaar A.O.
- Gault D.T.
5-year series of constricted (lop and cup) ear corrections: development of the mastoid hitch as an adjunctive technique.
Plast Reconstr Surg. 1998 Dec; 102 (discussion 2333–5): 2325-2332
- Ranjan P.
- Dalela D.
- Goel A.
- Sankhwar S.N.
- Singh V.
Scrotal hitch procedure to prevent apical necrosis of scroto-perineal flap for urethroplasty.
Int Urol Nephrol. Mar 2007; 39 (0301-1623): 119-121
3was done. 3 looped nylon sutures were used to lift up the internal portion of the sole bearing part of the flap and suspended onto periosteum of the lateral malleolus, navicular and posteromedial calcaneum (Figure 1). The flap hitch promotes adhesion and permanent uplift of the flap. This also produced a good contouring of the flap. Though flap hitch has been described in various parts of the body we do think this is worth considering in combination with flap thinning especially for the wobbly sole flap.
- Sullivan L.D.
- Masterson J.S.T.
- Wright J.E.
Vesicopsoas hitch: a versatile procedure.
Can J Surg. 1982; 25 (0008-428X): 26-29
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- 5-year series of constricted (lop and cup) ear corrections: development of the mastoid hitch as an adjunctive technique.Plast Reconstr Surg. 1998 Dec; 102 (discussion 2333–5): 2325-2332
- Scrotal hitch procedure to prevent apical necrosis of scroto-perineal flap for urethroplasty.Int Urol Nephrol. Mar 2007; 39 (0301-1623): 119-121
- Vesicopsoas hitch: a versatile procedure.Can J Surg. 1982; 25 (0008-428X): 26-29
Published online: May 14, 2012
Received: March 12, 2012
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.