[Reconstruction of heel: long-term follow up of 12 cases].

OBJECTIVE

To study long-term follow up result of fibula transplantation to reconstruct partial or complete defect of the heel.

METHODS

Heel defects were reconstructed by means of reverse transferring of combined vascular pedicled fibulaflap. The calcaneus was repaired by two segments of the fibula. Skin defects were covered by skin flap, and sensation was restored by anastomosing the sural nerve and medial pedal nerve. The residual cavity was filled by muscles surrounding the fibula to reconstruct the appearance of foot.

RESULTS

Four patients with complete heel defect and 8 with partial defect were operated on successfully. Two to 13 years(average 5.2 years) follow-up showed that the function and appearance of foot were normal and adaptive changes happened in the tissue of foot. The fibula was getting into a real cal caneous gradually. Besides this, the skin was thickened and the sensation was restored with the two-point discrimination of 0.8 to 3.0 cm. All patients resumed physical work. Comprehensive evaluation revealed that 11 patients were excellent and 1 was good in their functional recovery.

CONCLUSION

The results suggested that this operation is ideal for reconstructing heel defect. All kinds of tissues in heel can be reconstructed and more satisfactory function and appearance can be obtained through adaptive heel reshaping along with long-term walk.