Defects of fore foot repaired by reverse medial dorsal neurocutaneous flap of foot in emergency

Abstract

Objective To investigate the possibility of repairing the defects of fore foot by reverse medial dorsal neurocutaneous flap on foot in emergency.Methods Flap was designed along medial dorsal cutaneous nerve of foot,the axis of the medial branch was the line between lateral part of malleolar middle point and medial part of first metatarsophalangeal joint,and the axis of the lateral branch was the line between middle point of two malleolars and the tip of the great toe webspace,the pedicle located on the distant part of the foot.Based on the size of wound,the flap was cut off from the deep fascia layer,and medial dorsal cutaneous nerve of foot was anastomosed with nerve of digitales plantares proprii.All patients were operated in emergency.Results Eleven patients with defect of fore foot were perfectively recovered and all the wounds healed primarily.The appearances and functions of the foots were satisfactory,with two point sensation of 2-3 cm after 6-11 months postoperatively and without any skin fester.Conclusion Medial dorsal cutaneous nerve of foot has advantages as follows:simply procedures,avoidance of sacrificing major arteries,less harm to donor area,good recovery of sensation.So it is a good method to repair tissue defects of fore foot. Key words: Medial dorsal cutaneous nerve of foot; Surgical flaps; Transplantation; Microsurgery