Proximally Based Split Abductor Hallucis Turnover Flap for Medial Hindfoot Reconstruction: A Case Report |
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| Institution: | 2. Resident, Department of Podiatric Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, DC;3. Resident, Department of General Surgery, Medstar Georgetown University Hospital-Washington Hospital Center, Washington, DC;4. Surgeon, Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, DC;1. Resident, Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, DC;2. Resident, Department of Podiatric Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, DC;3. Resident, Department of General Surgery, Medstar Georgetown University Hospital-Washington Hospital Center, Washington, DC;4. Surgeon, Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, DC;1. Student, Western University of Health Sciences College of Podiatric Medicine, Pomona, CA;2. Chief Surgical Resident, SSM Health DePaul Hospital, St. Louis, MO;3. Student, Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona, CA;4. Resident, Medical City Forth Worth and University of North Texas Health Science Center, Fort Worth, TX;5. Resident, Einstein Healthcare Network, Philadelphia, PA;6. Resident, University of Missouri School of Medicine, Kansas City, MO;7. Resident, Mercy Health, Muskegon, MI;8. Professor, Department of Podiatric Medicine, Surgery, and Biomechanics, and Associate Dean of Clinical Education and Graduate Placement, Western University of Health Sciences College of Podiatric Medicine, Pomona, CA;9. Associate Professor, Department of Anatomy, Western University of Health Sciences College of Osteopathic Medicine of the Pacific and College of Podiatric Medicine, Pomona, CA;1. Resident, Orthopedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland;2. Head of Infectiology, Unit for Clinical and Applied Research, Balgrist University Hospital, University of Zurich, Zurich, Switzerland;3. Surgeon, Orthopedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland;4. Surgeon and Head of Technical Orthopedics, Orthopedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland;1. Surgeon, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany;2. Surgeon and Professor, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany |
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| Abstract: | 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. |
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