What is plantar flap?

The flap is marked on an axis between the sustentaculum of the talus and the medial aspect of the head of the first metatarsal. The flap is raised starting at the plantar aspect first, dissecting toward the dorsal aspect of the foot while deep to the muscular fascia over the flexor hallucis brevis muscle.

What does the medial plantar artery supply?

The medial plantar artery (latin: arteria plantaris medialis) is the smaller terminal branch of the posterior tibial artery. The medial plantar artery with its branches supply the muscles of the big toe, and the skin in the medial region of the sole. …

Where is medial plantar?

The medial plantar nerve is the larger one of the two terminal branches of the tibial nerve, it covers most of the sole of the foot and supplies multiple intrinsic muscles of foot.

What does the lateral plantar artery supply?

The lateral plantar artery (external plantar artery), much larger than the medial, passes obliquely lateralward and forward to the base of the fifth metatarsal bone….

What is the flexor digitorum brevis?

Flexor Digitorum Brevis is the central muscle of the superficial layer of the plantar foot muscles. It lies in the middle of the sole, immediately superior to the plantar aponeurosis and inferior to the tendon of Flexor Digitorum Longus.

Which artery do the medial and lateral plantar arteries arise from?

Posterior tibial artery
The medial plantar artery (internal plantar artery), much smaller than the lateral plantar artery, passes forward along the medial side of the foot….

What does the medial plantar nerve do?

The medial plantar nerve terminates as the proper digital plantar nerve and three common digital nerves, which innervate the flexor hallucis brevis and first lumbrical muscles, and supply sensation to the medial three toes and the medial aspect of the fourth toe7 (see Fig. 61-6).

Where do plantar arteries originate?

At the base of the first metatarsal bone, where it is much diminished in size, it passes along the medial border of the first toe, anastomosing with the first dorsal metatarsal artery….

How do you treat medial plantar nerve pain?

Treatment involves orthotics and immobilization. (See also Overview of Foot and Ankle Disorders.) Symptoms of medial and lateral plantar nerve entrapment include almost constant pain, with and without weight bearing, which helps to differentiate medial and lateral plantar nerve entrapment from plantar fasciosis.

What causes pain in the medial plantar nerve?

When there is repetitive impact to the abductor halluces muscle, such as during long distance running, the muscle can become swollen and inflamed. This then presses against the medial plantar nerve and causes the nerve to be compressed or entrapped. This is what causes the pain.

Which artery supplies blood directly to the plantar arch?

The plantar arch is a circulatory anastomosis formed from: deep plantar artery, from the dorsalis pedis – a.k.a. dorsal artery of the foot. lateral plantar artery….

What muscles does the posterior tibial artery supply?

The posterior tibial artery passes posterior to the popliteus muscle and pierces the soleus muscle. The posterior tibial artery then descends between the tibialis posterior and flexor digitorum longus muscles. The posterior tibial artery supplies blood to the posterior crural compartment.

Where does the medial plantar flap come from?

If a wider flap is necessary, the defect must be skin grafted. The medial plantar flap is supplied by a perforating system fro the medial plantar artery, a branch of the posterior tibial artery. The perforator exits between the abductor hallucis and flexor brevis muscles.

What kind of venous system is used for medial plantar flap?

The subcutaneous venous system draining to the saphenous vein is usually used, since it is larger in caliber and much thicker walled. Can be up to 3 centimeters. The skin and fascia over the medial aspect of the foot is thin, providing glabrous tissue for reconstruction of a variety of small soft tissue defects.

Where is the perforator located in the medial plantar artery?

The perforator from the medial plantar artery arises approximately a third of the way between the sustentaculum and the metatarsophalangeal joint. The location of the perforator is confirmed with a pencil Doppler.

Is the cutaneous vein on the medial plantar system small?

The vein on the medial plantar system can be quite small. If desired, a cutaneous nerve branch from the posterior tibial system can be incorporated into the flap and taken with a short leash. We prefer to use the cutaneous vein for venous drainage because its size and caliber make microanastomosis straight forward.