OBJECTIVETo investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects of forefoot.

METHODSIn the anatomic study, 50 cadaveric feet were injected with red latex and the anastomosis, distribution and external diameters of medialtarsal artery, medial anterior malleolus artery, medial plantar artery, the superficial branch of the medial basal hallucal artery and saphenousnerve nutritional vessels were observed. Based on anatomic research results, we designed the reverse saphenous nerve neurocutaneous flaps for repairing skin defects of forefoot.

RESULTSThe blood supply of reverse saphenous nerve neurocutaneous flaps were based on the vasoganglion, which consist of arterial arch at the superior border of abductor hallucis and arterial network on the surface of abductor hallucis around the saphenous nerve and medial pedis flap. From Oct. 2006 to Oct. 2011, the reverse saphenous nerve neurocutaneous flaps were used to repair skin defects of forefoot in 11 cases. The flap size ranged from 2.5 cm x 3.5 cm to 7.5 cm x 8.5 cm. The wounds at donor site were covered with full-thickness skin graft. All flaps survived completely with no ulcer at the donor site. 11 cases were followed up for 6 to 18 months( mean, 10 months). The skin color and texture were satisfactory. The patients could walk very well.

CONCLUSIONSIt is reliable to repair the skin defects of forefoot with reverse saphenous nerve neurocutaneous flaps. It is easily performed with less morbidity. This flap should be considered as a preferential way to reconstruct skin defects of forefoot.

Arteries ; anatomy & histology ; Cadaver ; Female ; Foot ; blood supply ; innervation ; Forefoot, Human ; injuries ; surgery ; Humans ; Male ; Muscle, Skeletal ; anatomy & histology ; Reconstructive Surgical Procedures ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; innervation ; Transplant Donor Site ; surgery

BACKGROUND: The Maasai are the most widely known African ethnic group located in Kenya and northern Tanzania. Most spend their days either barefoot or in their traditional shoes made of car tires. Although they walk long distances of up to sixty kilometers a day, they do not suffer from any foot ailments. Little is known about their foot structure and gait. The goal of this investigation was to characterize various aspects of Maasai foot in standing and walking. METHODS: Foot length, calf circumference, hindfoot alignment, step length, cadence, and walking velocity were obtained from 1,096 adult Maasai people (545 males and 551 females; mean age, 40.28 +/- 14.69 years; age range, 16 to 65 years). All included subjects were from rural areas, where the primary terrain was sandy soil, who spend most of their lifetime barefoot, walking. They all denied any medical history or previous symptoms related to foot problems. A trained clinician scanned all feet for deformities. Static (standing) and dynamic (walking) Harris mat footprints were taken to determine the distribution of forefoot pressure patterns during walking. RESULTS: The average foot length was 250.14 +/- 18.12 mm (range, 210 to 295 mm) and calf circumference was 32.50 +/- 3.22 cm (range, 25 to 41 cm). The mean hindfoot alignment was 6.21degrees +/- 1.55degrees of valgus. Sixty-four subjects (5.84%) had bilateral flat-shaped feet with a low medial longitudinal arch that exactly matched the broad pattern of their static footprints. Step length, cadence, and walking velocity were 426.45 +/- 88.73 cm (range, 200 to 690 cm), 94.35 steps/min (range, 72 to 111 steps/min), and 40.16 +/- 8.36 m/min (range, 18.20 to 63.36 m/min), respectively. A total of 83.39% subjects showed unilateral or bilateral deformities of multiple toes regardless of age. The most frequent deformity was clawing (98.79%) of which the highest incidence occurred with the fifth toe (93.23%). Dynamic footprints showed even pressure patterns throughout the forefoot (64.87%), followed by lateral forefoot pressure concentration patterns (21.81%). CONCLUSIONS: Our study shows the distinct parameters that provide more insight into the Maasai foot.
Adolescent ; Adult ; Aged ; Biomechanical Phenomena ; Ethnic Groups ; Female ; Foot/*anatomy & histology/*physiology ; Foot Deformities, Acquired/*epidemiology/ethnology ; Gait/*physiology ; Humans ; Kenya ; Male ; Middle Aged ; Rural Population ; Tanzania ; Walking/*physiology ; Young Adult

OBJECTIVETo investigate the morphological features of the perforator from the first plantar metatarsal artery, so as to provide anatomic basis for the reconstruction of soft-tissue defects of the forefoot.

METHODSThe first metatarsophalangeal joint was chosen as the landmark on 30 human cadaveric feet prefused with red latex. The following contents were observed under surgical magnifier: (1)The origin, courses,branches,distribution of the perforator of the first plantar metatarsal artery; (2)The anastomoses among the perforator of the first plantar metatarsal artery and other arteries on the medial aspect of the foot. Simulated operation was performed on one fresh specimen.

RESULTSThe perforator of the first plantar metatarsal artery passed through the space between the tendon, the abductor hallucis and the first metatarsal bone, and its entry point into the deep fascia was located (2. 3 ± 0.7 ) cm proximal to the first metatarsophalangeal joint. The perforator anastomosed with either the medial tarsal artery, the medial anterior malleolus artery or the branch of the medial plantar artery on the superior margin of the abductor hallucis, forming a longitudinal arterial chain,through which small branches were given off to the skin of the medial aspect of the foot. The perforator was( 1. 1 ± 0.2) mm in diameter and(3.2 ± 0.2) cm in length.

CONCLUSIONThe flap based on the perforator of the first plantar metatarsal artery can be harvested as an axial flap to repair the defects of soft tissue on the forefoot.

Anatomic Landmarks ; anatomy & histology ; Arteries ; anatomy & histology ; Cadaver ; Foot ; Foot Injuries ; surgery ; Humans ; Metatarsal Bones ; blood supply ; Metatarsophalangeal Joint ; anatomy & histology ; Muscle, Skeletal ; anatomy & histology ; Perforator Flap ; blood supply ; Reconstructive Surgical Procedures

Myiasis is usually caused by flies of the Calliphoridae family, and Cochliomyia hominivorax is the etiological agent most frequently found in myiasis. The first case of myiasis in a diabetic foot of a 54-year-old male patient in Argentina is reported. The patient attended the hospital of the capital city of Tucuman Province for a consultation concerning an ulcer in his right foot, where the larval specimens were found. The identification of the immature larvae was based on their morphological characters, such as the cylindrical, segmented, white yellow-coloured body and tracheas with strong pigmentation. The larvae were removed, and the patient was treated with antibiotics. The larvae were reared until the adults were obtained. The adults were identified by the setose basal vein in the upper surface of the wing, denuded lower surface of the wing, short and reduced palps, and parafrontalia with black hairs outside the front row of setae. The main factor that favoured the development of myiasis is due to diabetes, which caused a loss of sensibility in the limb that resulted in late consultation. Moreover, the poor personal hygiene attracted the flies, and the foul-smelling discharge from the wound favoured the female's oviposition. There is a need to implement a program for prevention of myiasis, in which the population is made aware not only of the importance of good personal hygiene and home sanitation but also of the degree of implication of flies in the occurrence and development of this disease.
Animals ; Argentina ; Diabetic Foot/*complications/parasitology/pathology ; Diptera/anatomy & histology/classification/*growth & development ; Humans ; Male ; Middle Aged ; Myiasis/*diagnosis/*parasitology ; Ulcer/*complications/parasitology/pathology

Brain ; physiopathology ; Female ; Foot ; anatomy & histology ; physiopathology ; Humans ; Meridians

OBJECTIVETo explore the blood supply of the reverse arterial arch at the superior border of the hallucal abductor island flap and provide an anatomical basis for repairing fore foot skin defect using this flap.

METHODSThe constitution, course, distribution, and external diameter of the arterial arch at the superior border of the hallucal abductor, and the concomitant veins and nerves were observed on 12 sides of formaldehyde-fixed and 12 fresh adult foot specimens perfused with red latex. The surgical approach using the arterial arch at the superior border of the hallucal abductor for repairing fore foot skin defect were designed.

RESULTSThe arterial arch at the superior border of the hallucal abductor, constituted by the branch of the medial tarsal artery or the branch of the anterior medial malleolus artery anastomosed with the superficial branch of the medial basal hallucal artery or the branch of the superficial branch of the medial plantar artery or the all the four branches, functioned as the axis of the medial tarsal, the medialis pedis and the medial plantar. The external diameters of the anterior medial malleolus artery, the medial tarsal artery, the branch of the superficial branch of the medial plantar artery, and the distal arterial arch at the superior border of the hallucal abductor were 1.02∓0.03 mm, 0.73∓0.04 mm, 0.56∓0.02 mm, and 0.53∓0.14 mm, respectively. Most of the arteries (91.67%) had one concomitant vein with the external diameters of 1.01∓0.03 mm, 0.81∓0.04 mm, 0.57∓0.01 mm, and 0.61∓0.02, respectively, and only a small fraction of them (8.33%) had two concomitant veins.

CONCLUSIONSThe fore foot skin defect can be repaired using this flap supplied by the branch of the anterior medial malleolus artery and the medial tarsal artery, the superficial branch of the medial plantar artery, or all the three. The pivot point formed by the neck of the first metatarsal or metatarsophalangeal joint allows for long vessel pedicles and larger flap areas to increase the flexibility of surgery.

Foot Injuries ; surgery ; Humans ; Muscle, Skeletal ; anatomy & histology ; blood supply ; Skin ; injuries ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply

In the long time of natural evolution, the bodies of some animals, such as feline, that live in the wild and complicate surroundings have evolved to possess outstanding buffering characteristics, which make the animals adapt to the environment perfectly. These animals generally have well-developed paw pads under their soles to play an important role in attenuating the intensity of impact when they land on the ground. Investigating the buffering characteristics of these animals' paw pads could help us to design "bionic" buffering and energy-absorption devices. In this paper, based on observations of animal jumping test, a simple mass-spring-buffer model was proposed to explore the buffering characteristics of the animals' paw pads. By analytically solving the differential equations of this model, the parameters concerned with paw pads functions were discussed and some significant results were obtained.
Adaptation, Physiological ; Animals ; Biomechanical Phenomena ; Felidae ; anatomy & histology ; physiology ; Foot ; anatomy & histology ; physiology ; Models, Theoretical

OBJECTIVETo investigate the anatomy of the medial pedis composite flaps with saphenous nerve and tendon and its application in the repair of tendo calcaneus and adjacent defects.

METHODS10 cadavers (20 sides) were observed. The origin, course, size and the distribution of the medial plantar artery were studied. 12 cases with tendo calcaneus and adjacent defects were reconstructed with the medial pedis composite flaps with saphenous nerve. Donor site defects were covered with free skin graft.

RESULTSThe medial plantar artery gives off deep branch [diameter (1.5 +/- 0.3) mm] and superficial branch [diameter (1.0 +/- 0.2) mm]. In 18 sides, the deep branches give off the medial branches and lateral branches. While in 2 sides, the superficial branches give off the medial branches and lateral branches with no big branches from the deep branches. There are branches of saphenous nerve and medial dorsal cutaneous nerve in the flap. All the flaps were survived. 8 cases were followed up for one months to one years. Good color, texture and function of the flaps were achieved.

CONCLUSIONSThe medial pedis composite flaps with saphenous nerve can repair tendo calcaneus and adjacent defects. It is a easy and safe procedure with reliable anatomy and good results.

Adolescent ; Adult ; Child ; Female ; Foot ; blood supply ; surgery ; Humans ; Male ; Peripheral Nerves ; anatomy & histology ; Surgical Flaps ; blood supply ; innervation ; Young Adult

It has been shown from medical researches that many diseases are major causes of foot morbidity, which are deeply related to the abnormality of the plantar pressure distribution. In this respect, we made a new type of conductive rubber sensor and designed a dynamic contact pressure measuring system of plantar-pressure distribution with 251 testing points successfully. It includes the multipoint conductive rubber sensor, the interface circuit and the computer data collecting and progressing system. The measuring system can give the intuitional and full-scale image results with the full-court, real time testing. Also in this paper are introduced the design of the system, the testing results, and its applications in primary medical studies.
Biomechanical Phenomena ; Equipment Design ; Foot ; anatomy & histology ; physiology ; Humans ; Pressure ; Stress, Mechanical ; Transducers, Pressure ; Walking ; physiology

OBJECTIVE: Comprehensively analysis the correlation and the law of variation between the height of a person and the length of his/her footprint. METHODS: Collecting footprint samples of those people of different age and sex from different area all of our country, and adopt the regressive analysis method to study these samples. RESULTS: A sum of useful data and regressive equation were obtained. CONCLUSION The correlation between the height of a person and the length of his/her footprint is obviously, the approximate height of a person can be reckoned according to thelength of his/her footprints.
Adolescent ; Adult ; Age Factors ; Body Height ; Female ; Foot/anatomy & histology* ; Forensic Medicine/methods* ; Humans ; Male ; Middle Aged ; Regression Analysis ; Sex Factors ; Shoes/classification*