Treatment of soft tissue defects in the heel often causes problems because of the anatomical structures of the foot and the foot's function in bearing the entire weight of the body. Various types of flap surgery have been tried, to deal with these problem areas. As ever, all the skin flaps lacked the normal quality of the plantar skin, which has fibrous septa with reduced flexibility. In view of the quality of the skin and subcutaneous tissue and the quality of the nerve supply, the technique of neurovascular island flaps for the plantaris medialis was used over the last 4 years in 14 patients, to conceal small to medium-sized heel defects. In this report, we examine anatomy, indication, technique, and results with regard to plantaris medialis island flaps. Their use is discussed in comparison with other types of flaps already used in this region.
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