Filleted toe flap for chronic forefoot ulcer reconstruction

Chronic plantar and dorsal forefoot ulcer may result from injury, structura l deformity, and abnormal sensation or circulation. It is not uncommon that the distal portion of the affected toes is deficient functionally in these patients. A filleted toe flap from the expendable functionless toe can pro vide a durable, stable, and sensate skin flap of 4 to 5.5 cm for coverage o f the forefoot defect. In this report, five cases of dorsal forefoot defect s and four cases of plantar forefoot defects due to ischemia (N = 3), troph ic change (N = 2), and diabetes (N = 4) were treated with filleted toe flap s. One flap failed due to postoperative deep infection. The other eight fil leted toe flaps survived but 2 patients underwent secondary amputations 7 m onths and 2 two years later because of secondary diabetic foot infections.