Medial plantar flap for hand reconstruction: A systematic literature review and its application for post-sarcoma excision

The reconstruction of soft tissue defects on the volar aspect of the hand represents a special challenge for the hand surgeon. Even though local and regional options have been described, in some cases because of their complexity, a free flap is preferred. The medial plantar free flap offers a unique reconstructive alternative by providing glabrous skin resurfacing for the palm and digits. The aim of this article is to present a systematic literature review on the use of the medial plantar free flap for hand surgery and a case report in which this flap was used for reconstructing a thenar eminence defect after sarcoma excision. Twenty-five relevant articles were found, and their findings are included in our study. The fasciocutaneous medial plantar flap and its musculocutaneous, flow-through, venous, perforator, and chimeric variants offer a wide range of reconstructive options for complex hand injuries.