Related Experiment Video
Updated: Nov 11, 2025
Engineered Vascularized Muscle Flap
Published on: January 11, 2016
Extensor digitorum brevis muscle flap for lower extremity coverage in a context of posttraumatic sepsis
Aurore Woussen1, Damien Feuvrier1, Édouard Woussen1
1Service de chirurgie orthopédique et traumatologique, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, CHRU Minjoz, 3, boulevard Alexander-Fleming, 25030 Besançon cedex, France.
Introduction:
Traumatic injuries to the distal quarter of the leg present a significant risk of skin necrosis and exposure of the underlying fracture site or the osteosynthesis material that often result in bone and joint infection. In the case of small or medium-sized bone exposure, local muscles may be one of the best options for lower extremity coverage. We describe our experience using the extensor digitorum brevis muscle flap in a context of posttraumatic bone and joint infection in fourteen patients. Our main objective was to assess the outcomes and the donor-site morbidity of the extensor digitorum brevis muscle flap.
Materials And Methods:
A single-center retrospective study in a French reference center for bone and joint infection from 2014 to 2018 reviewed cases of traumatic injuries with skin complications and bone and joint infection that required an extensor digitorum brevis muscle flap coverage. Fourteen patients were evaluated for early and late complications, 11 men and three women with a mean age of 51.4±17.72 (19-71) years. Seven of these were open fractures and nine cases were pilon fractures. Donor-site morbidity was assessed in nine patients.
Results:
Early flap complications included two cases (14.2%) of hematoma, one case (7.1%) of partial necrosis and four cases (28.5%) of donor-site dehiscence. Late complications caused by persistent infection were found in two patients (14.2%), with one case (7.1%) of chronic osteoarthritis and one case (7.1%) of septic pseudarthrosis. From a functional and cosmetic point of view, eight patients (89%) were satisfied, to very satisfied.
Conclusion:
Experience and a multidisciplinary approach are keys in providing an optimal treatment strategy for complex cases of bone and joint infection. The extensor digitorum brevis muscle is a reliable flap for small defects with underlying infection. Being made up of muscle tissue, this flap offers good resistance to infection and enables satisfactory distribution of antibiotics.
Level Of Evidence:
IV.
Related Concept Videos
01:28Muscles of the Leg that Move the Foot and Toes
Anterior Compartment
The anterior compartment includes muscles that contribute to the dorsiflexion of the foot. This compartment houses the tibialis anterior, extensor hallucis longus, and extensor digitorum longus muscles....
01:23Peripheral Artery Disease V: Postoperative Nursing Management