Digital Fillet Flaps: A Systematic Review

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Digital fillet flaps provide reliable vascularity and durable soft-tissue coverage.
• Their application in foot defect reconstruction remains underutilized despite availability.

Purpose of the Study:

• To systematically review the efficacy of digital fillet flaps for foot soft-tissue defects.
• To determine defect size coverage, complication rates, and flap durability.

Main Methods:

• Systematic review of 9 studies including 34 patients.
• Inclusion criteria: use of entire digit for soft-tissue coverage, reported complications, and follow-up.
• Therapeutic, Level IV evidence.

Main Results:

• Digital fillet flaps covered defects up to a mean size of 15.6 cm².
• Best coverage achieved for forefoot ulcerations.
• Complications included infection and partial/total flap necrosis; limited donor site morbidity.

Conclusions:

• Digital fillet flaps are effective for covering foot defects, especially forefoot ulcerations.
• They offer durable coverage for vital and osseous structures, withstanding weight-bearing forces.
• The procedure is simple, reduces operating time, and avoids complex reconstruction.