The extensor digitorum brevis island flap: possible applications based on anatomy

In the past few years, the proximally based extensor digitorum brevis island flap has been recognized as a useful method in the reconstruction of the lower extremity. The major goal of this study, which was performed in 16 cadavers, was to show the possible application of the extensor digitorum brevis island flap based on its anatomy. The vascularization and morphology of the muscle were also studied. We are able to show that, with sufficient mobilization of the vascular pedicle, the extensor digitorum brevis easily can reach both the lateral and the medial malleoli. In most cases, the island flap even reaches the Achilles tendon, the posterior aspect of the heel, and the lower to middle part of the anterior crural region. The vascular supply of the extensor digitorum brevis muscle shows a great consistency, with the lateral tarsal artery being the dominant supply of the muscle. The mean surface of 27 cm2 allows coverage of small to medium-sized defects.