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administered for 6 sessions. The wound healed without commonly associated with degloving of the heel pad.
[1]
any additional intervention [Figure 3d]. The heel pad flaps are typically elevated in a posterior
to anterior direction. Crush injuries may disrupt the heel
DISCUSSION pad in various flap patterns, which are medially based,
laterally based, medially and anteriorly based, or laterally
Crush injuries to the foot are a significant cause of and anteriorly based. In some cases, the soft tissues in the
morbidity among the working age population and are medial, posterior and lateral areas are disrupted, leaving

a b c d

e f g
Figure 1: (a) Crush injury to the right leg and foot region; (b) soft tissue loss anterior aspect of leg and dorsum of foot with heel pad avulsed from
the calcaneum with continuity to the proximal and the distal part; (c) soft tissue coverage of leg and dorsum of foot with latissimus dorsi free tissue
transfer; (d) free muscle tissue covered with split thickness skin graft; (e) status of heel region following debridement and hyperbaric oxygen therapy
after 3 weeks of injury; (f) postoperative picture following skin grafting over heel pad region; (g) late postoperative picture

Table 1: The patients treated for heel pad avulsion injury
No. Age (years)/ Mode of Base of Primary management Secondary
gender injury vascularity following debridement procedure
1 32/male RTA Distal Primary suturing
2 23/male RTA Distal Primary suturing
3 24/female RTA Distal Primary suturing SSG
4 42/male RTA Distal Primary suturing SSG
5 53/male RTA Distal Latissimudorsi flap
6 34/female RTA Distal Latissimus dorsi flap
7 42/male RTA Distal and lateral Primary suturing
8 27/male RTA Distal and medial Primary suturing
9 34/male RTA Distal Gracilis flap
10 5/male RTA Distal FTSG
11 52/female RTA Distal Primary suturing
12 25/male RTA Distal and lateral Primary suturing SSG
13 27/male RTA Distal and lateral Primary suturing
14 21/male RTA Distal and lateral Primary suturing SSG
15 28/male RTA Distal and lateral Primary suturing
16 43/male RTA Distal and lateral Primary suturing
17 42/male RTA Lateral and medial Primary suturing SSG
18 37/male RTA Distal and lateral Primary suturing
19 43/female RTA Proximal and distal Latissimus dorsi flap SSG
20 35/male RTA Distal and medial Primary suturing
21 39/male RTA Distal and medial Primary suturing
22 42/male RTA Distal and medial Primary suturing
23 45/male RTA Distal and medial Primary suturing SSG
24 21/female RTA Distal Primary suturing SSG
25 18/male RTA Proximal and distal Anchorage with K-wire SSG
26 47/male RTA Distal Reverse sural flap
27 42/male RTA Distal Anterolateral thigh flap
RTA: Road traffic accident, FTSG: Full thickness skin grafting, SSG: Split thickness skin grafting
58 Plast Aesthet Res || Vol 2 || Issue 2 || Mar 13, 2015