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Coimbatore, India.


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Foot and Ankle Reconstruction

Why are foot injuries so important?

Our feet are specialized structures that have evolved over millennia to support our weight during walking. Any injury threatens to upset this fine balancing game played by our feet. Fractures of the ankle or foot bones and wounds in the sole or foot therefore can lead to severe disability.

What are the common foot injuries?

Foot fractures are surprisingly common and thankfully most of them heal with a period of rest in correct position. But injuries with wounds, large or small, require more focused management. Especially troublesome to heal are wounds in the sole or heel, commonly the result of crushing injuries.

What is a 'crush' injury?

Severe injuries can be caused to the foot by it getting crushed between two surfaces. A common mechanism is the foot getting run over by a vehicle tyre. They are associated with multiple fractures in the foot with large wounds.

Why are heel and sole wounds so difficult to treat?

The sole contains the thickest layer of skin in the body to absorb the impact of walking/ running. So it is difficult to be replaced after an injury. Also the heel needs to have good sensation for proper walking and injuries that cause loss of this sensation lead to ulcer formation later.

So how can we treat them?

Apart from the minor injuries, others end up requiring complex procedures to allow fractures and wounds to heal. These include fixing the bone, grafting of skin and 'flap' surgeries.

What is 'flap' surgery?

Transferring tissue from one body region to another is called a flap surgery. If such tissue is completely detached from its original site with its blood vessels, this is called a free flap. Flaps are commonly employed by Plastic surgeons to let wounds heal.

What is recovery like after a severe foot injury?

Most foot injuries that end up needing Plastic surgery require a hospital stay of about a week. Bearing weight on the injured foot can take 2-3 months. However, the course can be much longer for injuries that border on amputation. Saving these feet necessitate multiple operations to allow the person to walk with them.

Child with dorsal foot exposed bones covered by a gracilis free flap.

Latissimus dorsi free flap cover of dorsum of foot.

Heelpad reconstruction by a gracilis free flap