A retrospective study on the medial plantar artery flap for heel pad reconstruction: Institutional experience from India

A retrospective study on the medial plantar artery flap for heel pad reconstruction: Institutional experience from India | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A retrospective study on the medial plantar artery flap for heel pad reconstruction: Institutional experience from India Ranga Dixit Rajan Yadavalli, Raveendra Reddy Ganji, Swathi Gagannatham This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8064971/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Purpose The heel pad is a specialized structure designed to resist repetitive mechanical stress during weight-bearing. This study evaluates our institutional outcomes with medial plantar artery flap for such defects and presents a technical modification in flap elevation from medial side to enhance surgical safety and reproducibility. Methods A retrospective review was conducted at the Department of Plastic Surgery, Sri Venkateswara Medical College, Tirupati, from 2022 to 2024. Twenty-four patients undergoing MPA flap reconstruction for heel pad defects were analyzed for demographic profile, etiology, flap dimensions, complications, and outcomes. The flap was raised from the medial side to facilitate early identification of the vascular pedicle and nerve. Results Of the 24 patients (16 males, 8 females; mean age 44.04 ± 11.2 years), trauma accounted for 83.3% (n = 20) of heel defects, while 16.6% (n = 4) were due to chronic diabetic ulcers. Complete flap survival was observed in 21 patients (87.5%), with 3 total losses (12.5%) due to pedicle compression (n = 2) and infection (n = 1). Postoperative complications occurred in 5 patients (23.8%) but were managed successfully. All surviving flaps achieved stable coverage, protective sensation by a mean of 10.8 ± 1.1 weeks, and weight-bearing ambulation by 7.2 ± 0.8 weeks. No donor-site morbidity or recurrence of the wound was noted at 12 months. Conclusions The medial plantar artery flap remains a reliable option for heel pad reconstruction, offering sensate and durable coverage for small to medium-sized defects. The medial-side elevation technique provides clearer anatomical identification and enhances flap safety. Trial Registration Not applicable Foot Injuries Plastic Surgery Procedures Surgical Flaps Medial Plantar Artery Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8064971","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":547520459,"identity":"590b9f2a-e498-4162-bf38-a0cb0fd87bbd","order_by":0,"name":"Ranga Dixit Rajan 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India","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Foot Injuries, Plastic Surgery Procedures, Surgical Flaps, Medial Plantar Artery","lastPublishedDoi":"10.21203/rs.3.rs-8064971/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8064971/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e\u003cp\u003eThe heel pad is a specialized structure designed to resist repetitive mechanical stress during weight-bearing. This study evaluates our institutional outcomes with medial plantar artery flap for such defects and presents a technical modification in flap elevation from medial side to enhance surgical safety and reproducibility.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003e A retrospective review was conducted at the Department of Plastic Surgery, Sri Venkateswara Medical College, Tirupati, from 2022 to 2024. Twenty-four patients undergoing MPA flap reconstruction for heel pad defects were analyzed for demographic profile, etiology, flap dimensions, complications, and outcomes. The flap was raised from the medial side to facilitate early identification of the vascular pedicle and nerve.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eOf the 24 patients (16 males, 8 females; mean age 44.04\u0026thinsp;\u0026plusmn;\u0026thinsp;11.2 years), trauma accounted for 83.3% (n\u0026thinsp;=\u0026thinsp;20) of heel defects, while 16.6% (n\u0026thinsp;=\u0026thinsp;4) were due to chronic diabetic ulcers. Complete flap survival was observed in 21 patients (87.5%), with 3 total losses (12.5%) due to pedicle compression (n\u0026thinsp;=\u0026thinsp;2) and infection (n\u0026thinsp;=\u0026thinsp;1). Postoperative complications occurred in 5 patients (23.8%) but were managed successfully. All surviving flaps achieved stable coverage, protective sensation by a mean of 10.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1 weeks, and weight-bearing ambulation by 7.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8 weeks. No donor-site morbidity or recurrence of the wound was noted at 12 months.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe medial plantar artery flap remains a reliable option for heel pad reconstruction, offering sensate and durable coverage for small to medium-sized defects. The medial-side elevation technique provides clearer anatomical identification and enhances flap safety.\u003c/p\u003e\u003ch2\u003eTrial Registration\u003c/h2\u003e\u003cp\u003eNot applicable\u003c/p\u003e","manuscriptTitle":"A retrospective study on the medial plantar artery flap for heel pad reconstruction: Institutional experience from India","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2026-01-09 19:05:15","doi":"10.21203/rs.3.rs-8064971/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2025-11-19 12:11:25","doi":"10.21203/rs.3.rs-8064971/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"92d8b3ae-2000-486b-8b78-fe20d6115552","owner":[],"postedDate":"January 9th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-03T13:54:00+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-09 19:05:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-8064971","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8064971","identity":"rs-8064971","version":["v2"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}