Extensor digitorum brevis flap on the treatment of lower limb injuries

Abstract

OBJECTIVE: To describe our pioneer national experience with 11 patients with soft tissue defects in the distal 1/3 of the leg, ankle and forefoot treated with extensor digitorum brevis muscle flap (EDB). METHODS: Between November 2009 and July 2012 11 patients were operated with the flap technique. We operated nine men and two women aged between 10 and 66 years. The surgical indications were acute trauma in four patients and post-traumatic osteomyelitis in seven patients. The small defects were covered ranging from 3x3 to 6x3 cm. The patch was applied with proximal stalk in most cases. RESULTS: Complete healing and infectious cure were obtained in all cases, despite one loss. CONCLUSION: The EDB flap is a feasible and safe technique to repair foot, ankle and distal leg losses. Suffering, dehiscence and delayed healing of the EDB end flap donor area may, however, occur. L-shaped incisions should be avoided for muscle lifting. Level of Evidence IV, Case series.

Versatility of the Extensor Digitorum Brevis Muscle Flap in Lower Limb Reconstruction

“…The morbidity and severe patient discomfort associated with this technique has reduced its popularity considerably. 19 As shown previously, the EDB-flap can be considered a good reconstructive option for small defects in the lower leg and foot region, 8,11,20 which also we have confirmed in this study. The small size and the thin contour of the flap in addition to the relative simplicity of harvesting are advantages that in some instances make the flap superior when compared with free tissue transfer or other local flap options.…”

“…Relatively few reports have been published describing the technique, the use and extended use of the EDB muscle flap. 3–11…”

Choosing between Muscle and Fasciocutaneous Free Flap Reconstruction in the Treatment of Lower Extremity Osteomyelitis: Available Evidence for a Function-Specific Approach

“…Of the 260 muscle flaps where total flap loss rates were discussed, 27 flaps or 10.4% experienced total flap loss. 9,[11][12][13][14][15]17,21,23,24,27,29 Two fasciocutaneous flap studies reported total flap loss totaling to 5.3% (n ¼ 1). 9,23 Both of the grouped fasciocutaneous and muscle flap studies reported total flap loss amounting to 6 of the 127 flaps, or 4.7%.…”

Therapeutic failure and eventual solution for skin necrosis and exposed tendon of the dorsum of the foot: A case report

“…Few useful wound‐covering methods exist for the dorsum site of the foot due to the limited amount of soft tissue . Previous research has suggested that treating with free flap (free abdominal muscle penetrating slit flap, anterolateral thigh free flap, peroneal free flap, scapular free flap) is useful for covering skin defects at the dorsum of the foot . Free flap requires trained microvascular surgeons and specialized flap monitoring; therefore, we chose EDB retrograde flap, which is relatively simple and the flap is covered with a pedicle .…”

“…Previous research has suggested that treating with free flap (free abdominal muscle penetrating slit flap, anterolateral thigh free flap, peroneal free flap, scapular free flap) is useful for covering skin defects at the dorsum of the foot . Free flap requires trained microvascular surgeons and specialized flap monitoring; therefore, we chose EDB retrograde flap, which is relatively simple and the flap is covered with a pedicle . The advantage to this flap is that collection is inconspicuous, ensuring little dysfunction, and little protrusion of the graft site .…”