Fifth toe Fillet Flap for Wound Coverage of Non-Healing Ulcer of the Foot: Surgical Technique and a Case Report

Sunny Chaudhary,Arvind Singh,Shivakumar A Bali,R K Siddharth

doi:10.47009/ajmr.2020.9.2.or2

Sunny Chaudhary, Arvind Singh + Show 2 more

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https://doi.org/10.47009/ajmr.2020.9.2.or2

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Abstract

Fillet flap is one of the options in the treatment of diabetic non-healing ulcers. The advantages of the fillet flap include the absence of donor site morbidity, excellent durability and preventing the need for more proximal amputation. A 56-year-old farmer presented to the out-patient department with complaints of a non-healing ulcer on the sole of the right foot for the past 7 months which was managed conservatively. A fifth ray partial amputation and a rotational flap of the redundant fifth finger for wound coverage were done. The wound healing was uneventful and the sutures were removed after two weeks. At the latest follow-up of 2 years, the patient was able to walk independently without pain and without any functional limitations. This case report describes the surgical technique of the lateral lesser toe fillet flap for wound closure on the plantar aspect of foot as an alternative to secondary healing or more proximal amputations.

Highlights

Fillet flaps are defined as axial flaps raised from amputated, discarded, or otherwise non-functioning or non-salvageable areas of the body
The conventional fillet flap described mainly for trauma has been extended to nontraumatic situations, such as defects caused by large pressure sores or for an extensive tumour resection, where they are raised from anatomically intact limbs.[4,5,6,7]
The advantages of the fillet flap include the absence of donor site morbidity, good durability and preventing the need for more proximal amputation for adequate soft tissue coverage

Summary

Introduction

Fillet flaps are defined as axial flaps raised from amputated, discarded, or otherwise non-functioning or non-salvageable areas of the body. The clinical outcomes of fillet flap coverage for pressure wounds or selected amputations (forefoot and trans-metatarsal) in diabetic patients have been proven to be reliable. The advantages of the fillet flap include the absence of donor site morbidity, good durability and preventing the need for more proximal amputation for adequate soft tissue coverage

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