足部皮膚欠損に対する有茎短趾伸筋弁の治療経験

抄録

Four patients underwent pedicled extensor digitorum brevis ( EDB ) muscle flap surgery for soft tissue defects of the foot. All of the patients were male, and their mean age was 46.5 years. The soft tissue defects had been caused by injuries sustained whilst operating machinery in two patients, skin necrosis in one patient, and a cellulitis-induced ulcer in the remaining patient. The EDB muscle flaps used included a reverse muscle flap, turnover EDB muscle flap, and a reverse EDB muscle flap of the lateral tarsal artery. Skin grafts were transferred to all of the muscle flaps, and complete coverage was obtained in all cases. We found that the use of an appropriately vascularized reverse EDB muscle flap is useful for reconstructing skin defects of the fore foot and toe. Furthermore, turnover EDB muscle flaps can be used to address skin defects of the medial dorsum pedis and preserve the dorsalis pedis artery. Similarly, reverse EDB muscle flaps of the lateral tarsal artery can be used to treat defects of the lateral dorsum pedis. Such flaps are also useful for treating dorsalis pedis artery insufficiency. In summary, EDB muscle flaps can be used and adapted to treat many skin defects of the foot.