The Extensor Digitorum Brevis as a Muscle Island Flap

Leitner, David W.; Gordon, Lewis R.; Buncke, Harry J.

doi:10.1097/00006534-198511000-00022

Cited by 57 publications

(10 citation statements)

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“…They also suggested that the flap can extend up to the lateral malleolar region without any difficulty. Subsequently, various authors have reported the advantages of ankle and foot soft tissue defect reconstruction using an EDB flap [19-21]. As the clinical applications of EDB free flaps are gaining increasing importance, the morphometric findings of the present study will be of help to plastic and orthopedic surgeons.…”

Section: Discussionmentioning

confidence: 68%

Analysis of the morphometry and variations in the extensor digitorum brevis muscle: an anatomic guide for muscle flap and tendon transfer surgical dissection

et al. 2013

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The extensor digitorum brevis muscle (EDB) is a practical option for use as an island flap or free flap when reconstructing soft tissue defects in the ankle as well as in the entire lower limb. It is frequently used to correct crossover toe deformity and other painful toe disorders. We evaluated the morphometry of the EDB in 44 formalin-fixed limbs. Length and width of the muscles were measured. Surface area was calculated as the product of length and width of the muscle. The length of each tendon was also measured from its origin to the point of distal attachment. Presence of any additional tendons was noted. Mean length, width, and surface area of the muscle were 7.39±0.71 cm, 4.1±0.37 cm, and 30.5±4.78 cm2 on the right side and 7.2±0.84 cm, 3.9±0.37 cm, and 28.4±5.35 cm2 on the left side, respectively. Morphometry of the tendons revealed that the tendon of the great toe had the highest mean length (9.5 cm) and the tendon of the fourth toe had the lowest mean length (6.3 cm). Four of the limbs studied (9.09%) had only three tendons. Three of the limbs studied (6.81%) had five tendons, and in one exceptional case (2.27%), six tendons were detected. These observations have significant value and are applicable to plastic and orthopedic surgery.

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Section: Discussionmentioning

confidence: 68%

Analysis of the morphometry and variations in the extensor digitorum brevis muscle: an anatomic guide for muscle flap and tendon transfer surgical dissection

et al. 2013

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“…The EDB muscle flap has been a selection for local soft tissue reconstruction since the 1970s. 1 – 3 EDB is located on the dorsum of the foot and supplements the action of extensor digitorum longus and extensor hallucis longus in extending the medial 4 toes. As such, it is expendable and may be used in reconstructions.…”

Section: Discussionmentioning

confidence: 99%

Unusual Vascular Supply to Extensor Digitorum Brevis

Silva

Hsieh

Gillies

2016

Plastic and Reconstructive Surgery - Global Open

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Summary:Lower limb reconstruction after a traumatic event has always been a challenge for plastic surgeons. The reliability of vessel integrity postinjury often drives us away from a local reconstructive option. With the advancement of computed tomography angiogram, it can not only demonstrate the continuation of major vessels but also helps to map the vascular supply at a perforator level. We hereby report an incidentally identified anatomical variant with dual dominant blood supply to the extensor digitorum brevis muscle from an extra branch of anterior tibial artery originated at midtibial level. This variant was picked up preoperatively by computed tomography angiogram and confirmed intraoperatively to be one of the dominant supply. We took advantage of this unusual anatomy by basing our reconstruction on this branch and hence spared the need to terminalize distal dorsalis pedis artery.

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“…The use of the extensor digitorum brevis muscle as a local muscle flap has been described in the published reports for reconstruction around the ankle and distal lower leg, but case numbers are limited. [16][17][18] The proponents of this flap argue the major advantages to be easy and rapid dissection, a constant vascular pedicle, a wide arc of rotation, minimal donor site morbidity and provision of bulk and well-vascularized muscle to obliterate dead space and deter infection. Apart from the dorsalis pedis artery being sacrificed in raising the flap, one obvious limitation of this flap in our setting is that disuse atrophy restricts its application.…”

Section: Discussionmentioning

confidence: 99%

Lateral Supramalleolar Flap in Reconstruction of Pressure Ulcers in Patients With Spinal Cord Injury

Sham

Choi

Flood

2008

ANZ Journal of Surgery

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Pressure ulcers are a major source of morbidity in patients with spinal cord injury. Soft tissue reconstruction of pressure ulcers around the lateral malleolar region continues to be a challenge. Numerous techniques have been described in the published reports, each with their own limitations. We review our clinical experience with the lateral supramalleolar flap for reconstruction of difficult lateral malleolar pressure ulcers in patients with spinal cord injury. This study is a retrospective review of all patients who underwent this procedure between 1991 and 2005. This fasciocutaneous flap is raised on a peroneal artery perforator as its pedicle, without compromising the three vessels supplying the foot. A split-skin graft is placed on the secondary defect. The patient remains in bed for 4-6 weeks before mobilization is allowed. Eight flaps on seven patients were carried out over the study period. Patients' age ranged from 37 to 67 years (mean 56.6 years). Three patients had procedures carried out on the right and three had on the left. One patient had bilateral procedures. All flaps survived, and there were no recurrences of the pressure areas. One patient had a small area of wound breakdown at the edge of the flap, requiring debridement and split-skin graft. Another patient developed a seroma under the split-skin graft over the secondary defect, which resolved with dressings. The lateral supramalleolar flap is a simple, safe and durable flap for lateral malleolar pressure ulcer reconstruction in patients with spinal cord injury.

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The Extensor Digitorum Brevis as a Muscle Island Flap

Cited by 57 publications

References 0 publications

Analysis of the morphometry and variations in the extensor digitorum brevis muscle: an anatomic guide for muscle flap and tendon transfer surgical dissection

Analysis of the morphometry and variations in the extensor digitorum brevis muscle: an anatomic guide for muscle flap and tendon transfer surgical dissection

Unusual Vascular Supply to Extensor Digitorum Brevis

Lateral Supramalleolar Flap in Reconstruction of Pressure Ulcers in Patients With Spinal Cord Injury

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