Use of the free medialis pedis flap in orofacial reconstruction: report of two cases.

The medialis pedis flap is a fasciocutaneous flap based on a branch of the medial plantar artery. The authors have used this flap in the reconstruction of skin defects of the hands and fingers because its skin is very similar in texture, color, and thickness. Because of its characteristics, this flap can also be applicable for orofacial reconstruction, when small or thin skin coverage is needed. Two cases are reported in which free medialis pedis flaps were used to reconstruct the eye socket in one patient and the alveolar ridge in the other. The authors concluded that the skin of the medialis pedis flap is not flexible enough and thus less suitable than the radial forearm flap for reconstruction of defects in which flexible skin is required, such as eye-socket reconstruction. However, reduced flexibility of the medialis pedis flap may provide an advantage in reconstruction of the gingiva and palate, where thin and rigid coverage is necessary.