Indication and practice of reverse flow extensor digitorum brevis muscle flap transfer.

Although the pedicled extensor digitorum brevis (EDB) muscle flap is a versatile flap, there are not many reports about it. Furthermore, there are few reports about the reverse vascular flow EDB muscle flap. The lateral tarsal artery coming from the dorsalis pedis artery nourishes the EDB muscle flap. Cutting the dorsalis pedis artery proximal to the flap can elevate this flap with reverse vascular flow. The authors treated eight patients with a reverse vascular flow EDB muscle flap. All flaps survived, with minor repair in two cases. The follow-up period ranged from 4 months to 1 year. This flap has two pivot points for creating a reverse vascular flow pedicled flap and a large arc of rotation for coverage of the dorsal foot. The authors confirmed that this flap is very versatile for soft-tissue reconstruction of the distal dorsum of the foot. The blood supply is reliable and the operative procedure is not complicated and can be performed under regional anesthesia. With this flap, a well-vascularized bed can be prepared for coverage with a skin graft. The major disadvantage is numbness in the first web of the foot, but this does not cause problems in daily life.