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The extensor digitorum brevis muscle flap in lower limb reconstruction: A long-term follow-up
Alexander Wyckman1, Jamila Hogey Halimi2, Elina Bergman2
1Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Orthopaedics in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Background:
The extensor digitorum brevis flap (EDB) is a small local muscle flap used primarily for the reconstruction of small tissue defects in the lower leg. Few studies investigate the long-term outcomes of the EDB flap, and concerns have been raised regarding long-term morbidity. The aim of this study was to investigate the long-term functional outcomes of the EDB flap.
Methods:
All patients who had a lower limb reconstruction using a pedicled EDB muscle flap between 1997 and 2021 were identified and asked to participate in the study. Twenty-one patients agreed to participate and were invited for a long-term follow-up visit, including measurements of range of motion (ROM), foot sensibility, and the presence of deformities of the foot and ankle. Patient-reported outcome measures were collected using the foot and ankle outcome score (FAOS) and the self-reported foot and ankle score (SEFAS). The patients' non-reconstructed feet were used as controls.
Results:
Decreased range of motion of the metatarsophalangeal joints was seen in the reconstructed side. None of the patients had a significant bowstringing phenomenon of the ankle or decreased sensibility of the foot dorsum. Six patients had some degree of lesser toe deformities. Worse SEFAS and FAOS scores were seen in patients who had EDB-reconstruction due to fracture-related soft tissue injuries.
Conclusion:
The long-term morbidity associated with the use of the pedicled EDB flap seems to be limited. This study may support the use of the EDB flap to reconstruct smaller defects of the lower leg; however, further studies including a larger number of patients would be of value.
