Proximally Based Split Abductor Hallucis Turnover Flap for Medial Hindfoot Reconstruction: A Case Report.

MedStar author(s):
Citation: Journal of Foot & Ankle Surgery. 58(6):1072-1076, 2019 Nov.PMID: 31679661Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical Care | Surgery/General Surgery | Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Foot Ulcer/su [Surgery] | *Free Tissue Flaps | *Muscle, Skeletal/tr [Transplantation] | *Needlestick Injuries/co [Complications] | *Reconstructive Surgical Procedures/mt [Methods] | Adolescent | Female | Foot Ulcer/di [Diagnosis] | Foot Ulcer/et [Etiology] | Humans | Magnetic Resonance Imaging | Needlestick Injuries/di [Diagnosis] | Needlestick Injuries/su [Surgery] | RadiographyYear: 2019Local holdings: Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007ISSN:
  • 1067-2516
Name of journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle SurgeonsAbstract: Limited reconstructive options exist for soft tissue defects of the foot and ankle because of a lack of surrounding tissue. Although microsurgical free flaps have become a popular treatment modality for this anatomic region, pedicled muscle flaps can provide robust coverage of small foot wounds with significantly less donor site comorbidity. One such muscle is the abductor hallucis, which can be used as a proximally based turnover flap to cover medial hindfoot defects. However, complete distal disinsertion of the muscle may lead to loss of support over the medial arch and first metatarsophalangeal joint, leading to pes planus and hallux valgus. In this case report, we describe a modified technique of a split abductor hallucis turnover flap for a young patient with a chronic, traumatic medial heel wound complicated by calcaneal osteomyelitis. By preserving part of the muscle's distal tendinous attachment, this technique allows for adequate soft tissue coverage while maintaining long-term biomechanical function. Copyright (c) 2019 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.All authors: Attinger CE, Evans KK, Gunsch C, Nigam M, Thompson C, Wang JSOriginally published: Journal of Foot & Ankle Surgery. 58(6):1072-1076, 2019 Nov.Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2019-11-19
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 31679661 Available 31679661

Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007

Limited reconstructive options exist for soft tissue defects of the foot and ankle because of a lack of surrounding tissue. Although microsurgical free flaps have become a popular treatment modality for this anatomic region, pedicled muscle flaps can provide robust coverage of small foot wounds with significantly less donor site comorbidity. One such muscle is the abductor hallucis, which can be used as a proximally based turnover flap to cover medial hindfoot defects. However, complete distal disinsertion of the muscle may lead to loss of support over the medial arch and first metatarsophalangeal joint, leading to pes planus and hallux valgus. In this case report, we describe a modified technique of a split abductor hallucis turnover flap for a young patient with a chronic, traumatic medial heel wound complicated by calcaneal osteomyelitis. By preserving part of the muscle's distal tendinous attachment, this technique allows for adequate soft tissue coverage while maintaining long-term biomechanical function. Copyright (c) 2019 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

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