[Reconstruction of soft tissue defects in distal dorsalis pedis with distally based medial dorsal neurocutaneous flap on foot].

OBJECTIVE: To investigate the surgical methods and clinical results of reconstructing soft tissue defects in distal dorsalis pedis with distally based medial dorsal neurocutaneous flap on foot.

METHODS: From January 2004 to July 2007, 11 cases of soft tissue defects in distal dorsalis pedis were treated with the distally based medial dorsal neurocutaneous flap on foot, including 8 males and 3 females aged 18-55 years. Nine cases were caused by crash and 2 cases were caused by traffic accident. There were 4 cases of tendon exposure and skin defects in the distal dorsalis pedis, 6 cases of bone exposure and skin defects in and adjacent to the first metatarsal head and 1 case of bone exposure and skin defects in the distal dorsalis pedis due to the third and fourth toe damage. The area of defects ranged from 3 cm x 3 cm to 7 cm x 5 cm. Distally based medial dorsal neurocutaneous flaps on foot were incised to repair the soft tissue defects and the size of the flaps ranged from 4 cm x 4 cm to 8 cm x 6 cm. Thickness skin graft was applied to repair donor site.

RESULTS: All the flaps survived and all wounds healed by first intention. Skin graft in donor site survived completely in 10 cases and survived partly in 1 cases (healing was achieved after the flap above lateral malleolus was used to repair). All cases were followed up for 6 months-1 year. The color, texture and thickness of the flaps were similar to those of recipient site. All patients returned to their normal weight-bearing walking. No skin ulceration in flaps and donor site was observed.

CONCLUSION: The operative technique of the distally based medial dorsal neurocutaneous flap on foot is simple, convenient and safe. The distally based flap is effective in repairing soft tissue defects of middle and small sized skin and soft tissue defects in distal dorsalis pedis.