Distal plantar area reconstruction using a flexor digitorum brevis muscle flap with reverse-flow lateral plantar artery

Abstract

It is difficult to resurface skin defects of the sole because of its unique anatomy, which is resistant to mechanical stimuli. Though various methods have been reported, few are functionally satisfactory, and it is especially difficult to repair the distal plantar area. We report a reconstruction of the distal plantar area using a flexor digitorum brevis muscle flap based on a reverse-flow lateral plantar artery pedicle in a patient with a malignant melanoma on the right lateral metatarsal head of the fifth toe. The muscle flap was sufficient to cover the exposed fifth metatarsal and was covered with a full-thickness skin graft. The result was favourable and the patient has a normal gait and no pressure sores.