Application of fibular side flap of the hallux in repairing minor-size tissue defect of forefoot / 中华骨科杂志

ABSTRACT

Objective To explore the curative effect of the treatment for minor-size tissue defect of forefoot by pedicle fibular side flap of the hallux.Methods The data of 12 patients with minor-size tissue defect of forefoot was retrospectively analyzed who were repaired with fibular side flap of the hallux from September 2003 to June 2012.There were 9 males and 3 females,with an average of 27 years (range,19-55 years).Among them,4 injured on the left,8 on the right side; 3 on the dorsal side and 9 on the plantar.There were 4 cases of traumatic wound,4 of tumor,2 of ulcer,and 2 of scar.Sizes of tissue defect were 1.3 cm×0.5 cm-2.5 cm×2.0 cm,the minimal flap size was 1.5 cm×0.8 cm,and the maximal flap size was 3.0 cm×1.5 cm.All flaps were elevated with fibular side artery and nerve of the hallux,and with width less than 1.5 cm,so wound of donor site could be sutured directly.The postoperative curative effect was assessed from five respects including flap healing,the sensation of the flaps,the flap appearance,the scar and weight-bearing walking.Results This kind of flap all survived successfully in the 12 cases,with satisfying cosmetic effect and sensory,without skin necrosis and blood vessel crisis.Nine patients were followed up for 3-96 months (average,12 months).The flaps were covered with soft and intact normal colored skin,no abrasion or wearing out happened and no subsequent reshaping was needed in the last follow-up.The minor-sized donor site wound could be sutured up directly.Since donor site was selected from non-weight-bearing area,walking and weight-bearing function of the patients were nearly unaffected at all.Sensory of the flaps were normal,with two-point discrimination ranging between 4-10 mm.Conclusion Due to the advantages of thinness,nerve nourishing,constant anatomical position and hidden position of donor site,anterograde fibular side flap of the hallux can be an ideal choice in repairing minor-size tissue defect of forefoot.