Indication and practice of reverse flow extensor digitorum brevis muscle flap transfer

Area of Science:

• Orthopedics
• Plastic Surgery
• Reconstructive Surgery

Background:

• The pedicled extensor digitorum brevis (EDB) muscle flap is a versatile surgical option.
• Limited reports exist on the reverse vascular flow EDB muscle flap, particularly regarding its application in foot reconstruction.

Observation:

• The lateral tarsal artery, originating from the dorsalis pedis artery, supplies the EDB muscle.
• By ligating the dorsalis pedis artery proximally, the EDB flap can be elevated with reversed vascular flow.
• Eight patients underwent reconstruction using the reverse vascular flow EDB muscle flap.

Findings:

• All eight flaps survived, with two requiring minor revisions.
• The flap demonstrated a large arc of rotation and two pivot points, suitable for covering the distal dorsum of the foot.
• The procedure is technically straightforward, can be performed under regional anesthesia, and provides a well-vascularized bed for skin grafting.

Implications:

• The reverse vascular flow EDB muscle flap is a reliable and versatile technique for soft-tissue reconstruction of the distal foot.
• Potential numbness in the first web space is a minor drawback, not impacting daily function.
• This flap offers a valuable alternative for complex foot reconstructions.