J Korean Soc Microsurg.  2013 May;22(1):38-41.

Reverse Dorsalis Pedis Flap Based on the Distal Communicating Artery of the Dorsalis Pedis Artery for the Reconstruction of the Forefoot Defect

• Kwon C
• Cho SH
• Eo SR

Abstract

A 31-year-old female patient presented with a skin and soft tissue defect measuring 8x6 cm in size with exposure of the extensor hallucis longus tendon and the first metatarsal bone after metatarsal lengthening for brachymetatarsia. The defect was covered with a distally based dorsalis pedis flap based on the distal communicating branch of the dorsalis pedis artery. Secondary defect was covered by a split thickness skin graft. There was congestion of the flap tip after the operation; however, it was resolved using medical leeches and anti-coagulants. No necrosis or infection was encountered and the contour of the flap was satisfactory. There was no donor site morbidity. Reverse dorsalis pedis flap has not been commonly used due to the anatomical variation and uncertainty, which is different from the reverse radial forearm flap. However, when faced with the challenge of a moderate soft tissue defect of the distal forefoot, we believe that the reverse dorsalis pedis flap offers a good option with various advantages.

Keyword

Surgical flap; Foot; Defects; Bone lengthening

MeSH Terms

Arteries
Bone Lengthening
Estrogens, Conjugated (USP)
Female
Foot
Forearm
Humans
Leeches
Metatarsal Bones
Necrosis
Skin
Surgical Flaps
Tendons
Tissue Donors
Transplants
Uncertainty
Estrogens, Conjugated (USP)