The Abductor Digiti Minimi Myocutaneous Island Flap: A Simple Solution for Small Lateral Foot Defects

Area of Science:

• Orthopedic Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Foot soft-tissue defects present significant surgical challenges.
• Local conditions like infection, exposed hardware, and fibrosis complicate reconstruction.
• Comorbidities such as vascular, metabolic, and neuropathic issues further increase complexity.

Purpose of the Study:

• To present a technical variation of the abductor digiti minimi (ADM) muscle flap.
• To incorporate a vascularized skin island overlying the ADM muscle for foot defect reconstruction.
• To evaluate the safety, efficacy, and outcomes of this modified flap.

Main Methods:

• Description of the anatomical basis and surgical technique for the modified ADM flap.
• Presentation of two clinical cases illustrating the flap's application.
• Assessment of coverage, healing, complications, and functional/aesthetic outcomes.

Main Results:

• The modified ADM flap provided stable and complete coverage in both reported cases.
• Reconstruction was successful even in patients with comorbidities and exposed internal fixation.
• The inclusion of a skin island allowed for immediate coverage, negating the need for secondary grafting.

Conclusions:

• The modified ADM flap with a skin island is a simple, safe, and reproducible technique.
• This variation expands local reconstructive options for small lateral foot defects.
• Further research is needed to establish its role in the broader foot reconstructive algorithm.