The reverse flow extensor digitorum brevis flap for dorsal foot defects-A single center study.

Background: Defects on the dorsum of the foot remain a reconstructive challenge for plastic surgeons. There are very few pedicled flaps that have a reach up to the distal foot and those too with a threat of poor perfusion. Very often distal foot has to be resurfaced with free flap even with small defects. This study describes our experience with the reverse extensor digitorum brevis muscle (EDB) flap for small- to medium-sized defects on the dorsum of the foot.

Methods: The study was conducted on 12 patients between February 2018 and March 2020 who presented with defects on the dorsum of the foot. The mean age of the patients was 30.8 years and the mean defect size was 20.17 cm. The EDB was applied on 10 male and 2 female subjects and resurfaced with a split thickness skin graft. The donor site was closed primarily.

Results: All flaps survived well. Two patients had small graft loss and 2 partial wound dehiscence of donor site, all of which healed on conservative treatment. Three patients had temporary sensory disturbance which resolved in few weeks.

Conclusion: The reverse EDB flap is a reliable flap for the coverage of small- to medium-sized dorsal foot defects. The flap has the advantage of robust vascularity, expendable muscle with little donor site morbidity, an easy to learn technique, short operating time, and acceptable esthetic outcome, and it can be used as the primary option in cases of small to medium dorsal foot defects.