The anatomy and clinical applications of the reverse medialis pedis island flap to repair of the forefoot skin detects.

Abstract

Objective To explore the methods of repairing forefoot skin detects by the reverse me-dialis pedis island flap. Methods The Anostomosis, distribution and external diameters of transverse artery of great too between with the branches of the first plantar metatarsal arteries and the deep branch of medial plantar artery were observed on 48 feet of adult cardaveric specimens. Artery angiography was performed in 5 fresh fools. Clinically, 12 cases of forefoot skin detects were repaired with the reverse medialis pedis island flap by 3 new methods. There were 11 males and 1 female. The patients ranged from 12 to 54 years old, with an average age of 32 years. Results Arterial circle under the first metatarsophalangeal joints consists of transverse artery of great too, tibial proper plantar digital artery of great toe, fibular proper plantar digital artery of great toe and the distal part of first plantar meatarsal artery. The arterial arch at the superior border of hallueal abductor and the medial branch of deep branch of medial plantar artery formed an arterial reten at abductor hallucis. Clinically, we designed 3 new methods to repair 12 cases of forefeet akin detects suc-cessfully with the reverse medialis pedis island flap. All patients were followed up, with the mean of 2 years. All flaps survived totally without diabrosis and swelling. The walking and weight-bearing were normal and the blood supply of foot was good. Conclusion The reverse point of the reverse medialis pedis flapis moved forward to the proximal phalanx, resulting in longer vessel pedieles and increasing the flexibility of clinical application. The skin flap thus formed is ideal for repair forefoot skin detects. Key words: Surgical flaps; Foot injuries; Treatment outcome