Abstract
A 45-year-old male presented with amputation of posterior heel soft tissue after an
accident involving broken glass panes. The defect measured 4 × 6.5 cm, and the composite
amputated tissue consisted of skin and subcutaneous layers. Intraoperative exploration
of the amputated tissue revealed 2 perforator arteries (diameter ≤0.4 mm) in the central
portion of the subcutaneous tissue and 4 superficial veins (diameter ≈0.6 mm) in the
wound margin. These vessels were anastomosed end-to-end to the corresponding vessels
from the wound bed using 11-0 nylon sutures. The replanted tissue survived completely.
The patient retained excellent aesthetic and functional outcomes at the 13-month follow-up
visit. The present case serves to demonstrate the feasibility of microsurgical replantation
for the posterior heel. Although such isolated amputations are far less common than
digital amputations, our experience suggests that microsurgical replantation is indicated
beyond the current spectrum of clinical repertoire.
Level of Clinical Evidence
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Successful replantation of an avulsed scalp by microvascular anastomoses.Plast Reconstr Surg. 1976; 58: 133-136
- Successful replantation of an amputated upper lip.Plast Reconstr Surg. 1984; 73: 664-670
- Microsurgical replantation of a completely amputated penis and scrotum; case report.Plast Reconstr Surg. 1977; 60: 287-291
- Successful replantation of an amputated tongue.Plast Reconstr Surg. 1998; 101: 1604-1607
- Microsurgical replantation of a partial helix of the ear.Microsurgery. 2009; 29: 548-551
- Replantation of the heel in a child.Ann Plast Surg. 1979; 2: 154-157
- Successful replantation of the heel pad: a seven-year follow-up.Ann Plast Surg. 1989; 22: 350-353
- Heel replantation and subsequent analysis of gait.Plast Reconstr Surg. 1993; 91: 729-733
- Replantation of the heel pad.Plast Reconstr Surg. 1993; 92: 537-539
- Heel replantation.Br J Plast Surg. 1998; 51: 473-475
- The unstable posterior heel scar: reconstruction using the reverse sural artery adipofascial flap.Ann Plast Surg. 2007; 58: 222-223
- Various applications of the medial plantar flap to cover the defects of the plantar foot, posterior heel, and ankle.Ann Plast Surg. 2003; 50: 498-503
- A case of nonisland pedicled foot fillet flap for below-knee amputation stump wound: treatment option for compartment syndrome after fibular free flap surgery.J Korean Med Sci. 2014; 29: 305-308
- A new strategy of fingertip reattachment: sequential use of microsurgical technique and pocketing of composite graft.Plast Reconstr Surg. 2001; 107: 73-79
Article info
Publication history
Published online: March 22, 2018
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
