Sensate sole-to-sole reconstruction using the combined medial plantar and medialis pedis free flap

The coverage of soft-tissue defects of the sole needs special consideration because of the forces of weight bearing on the reconstruction. A variety o f free tissue transfers have been advocated for soft-tissue replacement of the weight-bearing portions. However, there is no doubt that the ideal tiss ue for resurfacing the sole is the plantar tissue itself. The authors prese nt a case of reconstructing the sole with the combined medial plantar and m edialis pedis free flap that involves approximately 70% of the weight-beari ng portion. This contralateral, combined fasciocutaneous free flap based on the posterior tibial-medial plantar vascular system is a good alternative in covering extensive sole injuries.