Functional integrity of fasciocutaneous flaps: biomechanical evaluation of selected kinetic variables

In the recent years advancements in microsurgery allow the free tissue transfer for reconstruction of soft tissue defects in the plantar surface of the foot. Fasciocutaneous flaps are one of the available options to the reconstructive surgeon. The present study investigated the functional integrity of selected fasciocutaneous flaps during walking. Five subjects were included in the study. Center of pressure patterns and ground reaction force parameters were investigated. An algorithm for the accurate determination of the center of pressure path was developed. Forces were normalized to body weight. Timing of gait events was normalized to stance phase. Support times of the reconstructed foot were greater than support times for the normal foot. The center of pressure identified gait adaptations of the reconstructed foot. Impact peak force was absent in most subjects. Vertical loading was less than normal. Fore-aft shear was less than normal. The medial force was less than normal too, but the lateral force was variable among subjects. It may be speculated that the kinetic patterns observed were sensitive to age, location, and size of the flaps. The fasciocutaneous flaps should be included in the surgeons' armentarium for reconstruction of soft tissue defects on the sole of the foot.