Reconstruction of the great toe using a pedicled medial plantar flap with anterograde venous drainage

Abstract

A pedicled medial plantar flap with anterograde venous drainage may be a useful alternative option for the reconstruction of relatively large great toe defects.

Toe resurfacing with a thin thoracodorsal artery perforator flap

“…Various kinds of flaps can be used for reconstructing the great toe . Pedicled flaps have been used for toe resurfacing; these include reverse dorsalis pedis flaps, reverse metatarsal artery perforator flaps, medial plantar flaps, and reversed tibialis anterior flaps . However, pedicled flaps have limitations in size, rotation arc, and approach and may not be available if there is concomitant proximal foot or leg injury .…”

“…Hence, toe resurfacing rather than amputation might be considered, much as hand reconstruction is, for patient satisfaction and demand. Previous studies regarding reconstruction of foot defects have described loco‐regional flaps such as reverse dorsalis pedis flaps, reverse metatarsal artery perforator flaps, medial plantar flaps, and reversed tibialis anterior flaps, and free flaps including peroneal, soleus, lateral forearm, and scapular flaps …”

Coverage of defect over toes after failure of microsurgical replantation with medial sural artery perforator flap: A case report

“…Skin grafting on the sole is not a good option in most cases due to weakness to the weight bearing stress and often leads to hyperkeratosis or chronic ulcers. Recently, pedicled flaps have been described for the distal foot area using perforator‐based propeller flap or changing the venous drainage, but local flaps are often questionable due to local trauma as well as limited reach to the distal toes and unreliability of flap circulation in some cases. Free tissue transfer techniques are free from this limitation when there are suitable recipient and donor vessels.…”

The bipedicled medial plantar flap: Vascular enhancement of a reverse flow Y–V medial plantar flap by the inclusion of a metatarsal artery perforator for the reconstruction of a forefoot defect—A case report

“…As described by Martin et al (1991) in their paper, by tailoring in a "Y to V" fashion, the MP flap pedicle, a considerable gain in the arc of rotation can be obtained permitting coverage of more distant defects of the plantar foot. One of the main disadvantages of this flap, as in other reverse-flow variants of the MP flap (Oberlin, Accioli de Vasconcellos, & Touam, 2000), is an unreliable venous drainage (Acikel, Celikoz, Yuksel, & Ergun, 2003;Akita et al, 2014;Beidas, Tan, & Petersen, 2012;Masuoka & Kato, 2004;Park, Lee, Lee, & Baek, 2017).…”