MUSCULOFASCIAL FLAPS BASED ON THE DORSALIS-PEDIS VASCULAR PEDICLE FORCOVERAGE OF THE FOOT AND ANKLE

Soft-tissue reconstruction of the foot and ankle has long presented ch allenging problems for the plastic surgeon. Limitations of available l ocal tissue, the need for specialized tissue, and donor site morbidity restrict the options available to the reconstructive surgeon. In an e ffort to solve these difficult problems, we have begun to use musculof ascial flaps based on the branches of the dorsalis pedis artery. We pr esent our early experience of 5 patients treated with an extensor digi torum brevis muscle flap with fascial extensions often containing the contents of the first web space. Our patients ranged from 6 to 60 year s in age and included 4 males and 1 female. The etiologies of the woun ds were secondary to trauma (N = 2), complications of surgery for rheu matoid arthritis (N = 2), and were secondary to a defect following res ection of an arteriovenous malformation (N = 1), The flaps had antegra de blood flow in 3 patients and reverse flow in 2 patients. The flaps were covered with a split-thickness skin graft and the donor site was closed primarily. The donor sites healed without the need for further surgery. One patient required additional procedures. This flap proved to be both versatile and effective for closure of difficult wounds of the foot and ankle.