CC BY-NC-ND 4.0 · Indian J Plast Surg 2008; 41(01): 62-66
DOI: 10.1055/s-0039-1699230
Case Report
Association of Plastic Surgeons of India

Coverage of defects over toes with distally based local flaps: A report of four cases

Ashok Raj Koul
Department of Plastic and Reconstructive Surgery, Medical Trust Hospital, Cochin - 682 016, Kerala, India
,
Rahul K. Patil
Department of Plastic and Reconstructive Surgery, Medical Trust Hospital, Cochin - 682 016, Kerala, India
,
Vinoth Kumar Philip
Department of Plastic and Reconstructive Surgery, Medical Trust Hospital, Cochin - 682 016, Kerala, India
› Author Affiliations
Further Information

Publication History

Publication Date:
15 January 2020 (online)

ABSTRACT

reconstruction of the distal foot, especially of the toe has always been a challenging problem. various methods have been tried with variable success rates and limitations. presented here is a series of four cases, where distally based flaps were used. two of them were extensor digitorum brevis (edb) muscle flaps and the other two were first dorsal metatarsal artery (fdma) based skin flaps. one in each of the two was augmented with a plantar v-y advancement flap. all flaps survived completely without any flap- or donor site-related complications. the patients were ambulated two weeks following the reconstruction and were symptom-free after an average follow-up of thirteen months. distal flaps based on the dorsalis pedis system provide a reliable cover for distal foot defects.

 
  • 1 Ishikawa K, Isshiki N, Suzuki S, Shimamura S. Distally based dorsalis pedis island flap for coverage of the distal portion of the foot. Br J Plast Surg 1987; 40: 521-5
  • 2 Hayashi A, Maruyama Y. Reverse first dorsal metatarsal artery flap for reconstruction of the distal foot. Ann Plast Surg 1993; 31: 117-22
  • 3 McCraw JB, Furlow Jr LT. The dorsalis pedis arterialized flap: A clinical study. Plast Reconstr Surg 1975; 2: 177-85
  • 4 Bakhach J, Demiri E, Chahidi N, Baudet J. Extensor digitorum brevis muscle flap: New refinements. Plast Reconstr Surg 1998; 102: 103-10
  • 5 Man D, Acland RD. The microarterial anatomy of the dorsalis pedis flap and its clinical applications. Plast Reconstr Surg 1980; 65: 419-23
  • 6 Ohmori K, Harii K. Free dorsalis pedis sensory flap to the hand, with microneurovascular anastomosis. Plast Reconstr Surg 1976; 58: 546-54
  • 7 Patzakis MJ, Wilkins J, Moore TM. Use of antibiotics in open tibial fractures. Clin Orthop Relat Res 1983; 178: 31-5
  • 8 Attinger C.. Soft tissue coverage for lower extremity trauma. Orthop Clin North Am 1995; 26: 295-334
  • 9 Attinger CE, Ducic I, Cooper P, Zelen CM. The role of intrinsic muscle flaps of the foot for bone coverage in foot and ankle defects in diabetic and nondiabetic patients. Plast Reconstr Sur 2002; 110: 1047-54
  • 10 Ger R.. The management of chronic ulcers of dorsum of foot by muscle transposition and free skin grafting. Br Jr Plast Surg 1997; 29: 199-204
  • 11 Karp NS, Kasabian AK, Siebert JW, Eidelmann Y, Colen S. Microvascular free-flap salvage of the diabetic foot: A 5-year experience. Plast Reconstr Surg 1994; 94: 834-40
  • 12 Robinson DW. Microsurgical transfer of the dorsalis pedis neurovascular island flap. Br J Plast Surg 1976; 29: 209-13
  • 13 McCraw JB. Selection of alternative local flaps in the leg and foot. Clin Plast Surg 1979; 6: 227-46
  • 14 Sakai S.. A distally based island first dorsal metatarsal artery flap for coverage of a distal plantar defect. Br J Plast Surg 1993; 46: 480-2
  • 15 Earley MJ, Milner RH. A distally based first web flap in the foot. Br J Plast Surg 1989; 42: 507-11
  • 16 Smith AA, Arons JA, Reyes R, Hegstad SJ. Distal foot coverage with a reverse dorsalis pedis flap. Ann Plast Surg 1995; 34: 191-6
  • 17 Wang X, Qiao Q, Burd A, Qi K. Reconstruction of distal foot wounds with reverse first dorsal metatarsal artery flap. Burns 2005; 31: 1025-8
  • 18 Pallua N, Di Benedetto G, Berger A. Forefoot reconstruction by reversed island flaps in diabetic patients. Plast Reconstr Surg 2000; 106: 823-7
  • 19 Governa M, Barisoni D. Distally based dorsalis pedis island flap for a distal lateral electric burn of the big toe. Burns 1996; 22: 641-3
  • 20 Landi A, Soragni O, Monteleone M. The extensor digitorum brevis muscle island flap for soft tissue loss around ankle. Plast Reconstr Surg 1985; 75: 892-7
  • 21 Leitner DW, Gordon L, Buncke HJ. The extensor digitorum brevis as muscle island flap. Reconstr Surg 1985; 76: 777-80
  • 22 Mathes SJ, McCraw JB, Vasconez LO. Muscle transposition flaps for coverage of lower extremity defects: Anatomic considerations. Surg Clin North Am 1974; 54: 1337-54