Lateral Malleolar Defect Coverage Using Abductor Digiti Minimi Muscle Flap.

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• The lateral malleolar region is susceptible to trauma and ulceration.
• Reconstructing defects in this area, especially with exposed structures, presents a surgical challenge.
• Existing methods like free flaps or skin grafts have limitations and potential complications.

Purpose of the Study:

• To evaluate the efficacy of the abductor digiti minimi (ADM) muscle flap for reconstructing lateral malleolar defects.
• To assess the ADM flap's outcomes in patients with foot ulcers involving exposed bone, joint, or tendons.

Main Methods:

• A retrospective review of 8 patients who underwent ADM muscle flap reconstruction for foot ulcers between 2013 and 2016.
• The ADM muscle flap was used to fill dead space and provide vascularized coverage.
• Split-thickness skin grafts were used for coverage when necessary.

Main Results:

• Complete healing was achieved in all 8 cases.
• The ADM muscle flap provided durable, shock-absorbent coverage.
• No recurrence of ulcers was observed during a mean follow-up of approximately 2 years.

Conclusions:

• The ADM muscle flap is a versatile and effective option for reconstructing lateral malleolar soft tissue defects.
• It offers advantages over free flaps and skin grafts, including no donor site morbidity and good functional outcomes.
• This technique facilitates healing and allows patients to resume normal daily activities without affecting limb movement.