Bibliographic record
Abstract
BACKGROUND: Full-thickness defects to the plantar surface of the foot present a challenge to the reconstructive surgeon. Skin grafts and a variety of flap procedures have been described to resurface this site, but not all achieve a return to normal foot function. For the plantar surface of the heel, the previously described medial plantar flap can produce successful results. However, this method leaves a donor site, which requires skin grafting. This is a report of a modification of the medial plantar flap into a V-Y configuration that allows direct closure of the donor site. METHODS: Three defects of the plantar surface of the heel were resurfaced: case 1, a spina bifida patient with a 45-mm-wide debrided pressure sore; and cases 2 and 3, patients with defects resulting from wide excisions of melanomas that were 47 and 57 mm wide, respectively. Patients in cases 2 and 3 were reviewed at 1 year for mobility, gait, and sensation in the flap. RESULTS: The patients in cases 2 and 3 were able to attain full, unrestricted mobility and objectively near-normal sensation of the resurfaced skin. In the patient in case 1, a problematic pressure sore was healed after an intermediate period of wound dehiscence, with a robust, bulky flap. CONCLUSIONS: This modified flap retains the advantages of the traditional medial plantar flap while minimizing its donor-site problems. It has permitted satisfactory long-term functional results, optimizing restoration of foot function, and is a useful option that can be considered for resurfacing the problematic plantar surface of the heel.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".