The extended digitorum brevis muscle flap

The anatomy of the anterior tibial artery was studied in eight fresh cadavers. Consistently no major branches were found to the long toe extensor or anterior tibial muscle in the segment 15 cm preceding the lateral malleolus. This allowed the use of the extensor digitorum brevis muscle on a long anterior tibial vascular pedicle following release of the extensor retinaculum. The longer pedicle made this reliable muscle flap suitable for coverage of mid and lower tibial defects, in addition to ankle defects, as an alternative to free flaps. Its use is described in three complex cases.