Experience With the Extensor Digitorum Brevis Muscle Flap for Foot and Ankle Reconstruction

In Brief Soft tissue defects of the foot and ankle region are difficult to treat, given the lack of local flaps. Some methods available are unreliable, multistaged, have significant donor-site morbidity, or are technically complex, requiring significant training and postoperative equipment or monitoring not available at all institutions. We report the largest experience using the extensor digitorum brevis muscle flap for foot and ankle reconstruction. The charts of 20 patients were retrospectively reviewed. Eighty-five percent of the wounds were successfully treated with this flap, with minimal donor-site morbidity. The extensor digitorum brevis muscle flap has minimal morbidity, is easy to elevate, does not require microsurgical skills, and can be performed at most institutions. The extensor digitorum brevis muscle flap is a practical option for wounds located at the foot and ankle region and should be considered in patients potentially requiring a free flap. Seventeen of 20 foot and ankle reconstructions were successfully performed with extensor digitorum brevis muscle flaps. Three flap failures required subsequent free flap salvage, while 3 seromas and 3 partial dehiscences were managed nonoperatively.