EXTENSOR DIGITORUM BREVIS MUSCLE FLAP - NEW REFINEMENTS

Two original operative techniques of raising the extensor digitorum br evis muscle flap are presented. These methods allow for covering dista l foot defects that are difficult to cover by other reconstructive mea ns. In the fir-st technique, the flap is based on an extended distal p edicle supplied by the dorsal interosseous artery of the first interme tatarsal space. In the second technique, the flap receives its vascula r supply fi-om the medial tarsal artery; this procedure may be valuabl e when the vascular supply of the dorsalis pedis pedicle has been disr upted. To confirm the availability of these vascular pedicles, cadaver dissections were performed and proved that the extended pedicle disse ction enhances the rotation are of the flap. Four selective clinical c ases, in which the flap was successfully used, are discussed. Advantag es of these techniques, in reconstructing large defects in the distal foot, are delineated.