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A distally based median plantar flap.

J Amarante¹, A Martins, J Reis

¹Plastic Surgery Department, Hospital S. João, Porto, Portugal.

Annals of Plastic Surgery

|May 1, 1988

Summary

Reconstructing the first metatarsophalangeal joint is challenging. A modified cross-foot flap technique using reversed blood flow in a distal vascular pedicle offers a single-stage solution for defects in this area.

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Area of Science:

Orthopedic surgery
Plastic and reconstructive surgery

Background:

Reconstruction of the first metatarsophalangeal joint presents unique challenges due to the need for durable, sensitive, and friction-resistant skin coverage.
The medial plantar island flap, traditionally used for heel defects, has been adapted as a cross-foot flap for first metatarsophalangeal joint reconstruction, often requiring a secondary procedure.

Observation:

The anteromedial aspect of the foot is a common site for defects requiring reconstruction.
Traditional flap reconstructions for this area can be cumbersome and necessitate multiple surgical interventions.

Findings:

A novel single-stage surgical technique is presented, utilizing a cross-foot flap based on reversing blood flow in a distal vascular pedicle.
This modified flap design addresses defects of the anteromedial aspect of the foot, specifically targeting the first metatarsophalangeal joint area.

Implications:

This innovative approach simplifies the reconstructive process for first metatarsophalangeal joint defects, potentially reducing patient morbidity and healthcare costs.
The technique yields favorable functional and aesthetic outcomes, offering a valuable alternative for complex foot reconstructions.

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