First Dorsal Metatarsal Artery Flap for Coverage of Soft Tissue Defects of the Distal Foot: Delayed Technique, Proximal and Distally Based Fasciocutaneous and Adipofascial Variants

Abstract

Orthoplastic surgeons continue to encounter challenges for both proximal and distal soft issue defects in the foot. Patients with significant comorbidities often are nonideal surgical candidates. Distal free flaps historically have been utilized. The first dorsal metatarsal artery flap is a local flap with several variants, making it a versatile option in the orthoplastic surgeon's armamentarium for treatment of challenging soft tissue defects about the foot and ankle. The vascular tree is variable and preoperative vascular identification is required to determine flap design.

Keywords: Distal foot pathology; Distal soft tissue defects; First dorsal metatarsal artery flap.