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Medialis Pedis Flap in the Reconstruction of Palmar Skin Defects of the Digits: Clarifying the Anatomy of the Medial Plantar Artery

Rodriguez-Vegas, Manuel MD

doi: 10.1097/SAP.0b013e318268a901
Hand Surgery

Because of its outstanding texture, bulkiness, pliability and sensory recovery, the medialis pedis is an excellent alternative in the reconstruction of complex volar skin defects of the digits in selected patients. However, the surgical flap anatomy related with the medial plantar artery is still somewhat confusing to the point that the different journal articles and anatomy textbooks and atlases use different terminology and are, to some extent, misleading and/or incomplete. The authors report a clinical series of 15 medialis pedis free flaps in the reconstruction of skin defects of the fingers and evaluate their indications in free flap reconstruction of the skin defects of the digits. A review is made of the most relevant journal articles, anatomy textbooks, and atlases that describe the anatomy of the medial plantar artery with a special emphasis on the cutaneous branches that nourish the medialis pedis flap.

From the Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery, Diplomate of the European Federation Societies for Surgery of the Hand, and Plastic, Hand and Reconstructive Microsurgery Hospital Quirón, Madrid, Spain.

Received May 10, 2012, and accepted for publication, after revision, July 8, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Manuel Rodríguez Vegas, MD, Plastic Surgery and Reconstructive Microsurgery. Hospital Quirón. C/ Diego de Velazquez 1, Madrid, Spain. E-mail:

© 2014 by Lippincott Williams & Wilkins