Reverse Distally Based Abductor Hallucis Muscle Flap for Soft Tissue Coverage of the First Metatarsophalangeal Joint Wounds

Abstract

Loss of soft tissue coverage distally around the foot poses threats of amputation of the exposed boney structures. An amputation of a portion of the foot leads to loss of the biomechanical structural integrity of the foot. This promulgates an imbalance with its inherent risks of developing new ulcers. This in turn potentiates the limb loss cycle. The reverse abductor hallucis muscle flap is ideally suited for small to moderate-sized defects in the vicinity of the first metatarsophalangeal joint based on its arc of rotation. In this article, we present cases of 5 patients who failed local wound care and healing by secondary intention for at least 6 months duration. The patients were treated successfully using reverse abductor hallucis muscle flap.

Proximally based Abductor hallucis muscle flap in the treatment of osteomyelitis complicated Lisfranc fracture dislocation: A Case Report

“…Based on what has been documented in literature, the abductor hallucis muscle flap proximally or distally based with and without conjoined local fasciocutaneous flaps has been used with success for defects of different etiologies and localities including medial and plantar forefoot, midfoot, medial hindfoot, but also defects of the Achilles, and medial ankle. 1,[3][4][5][6][7][8][9][10][11][12][13] Reports pertaining to midfoot defects have described the use of the abductor hallucis muscle flap for charcot arthropathy with concomitant osteomyelitis of the midfoot, and modern warfare resulting blast injuries with significant loss of soft tissue and bone. 8,9,13 Our understanding of the abductor hallucis muscle flap use from aforementioned publications is derived mostly from case reports.…”