title: Reverse first dorsal metatarsal artery flap for reconstruction of traumatic defects of dorsal great toe.
abstract: BACKGROUND
  Soft-tissue defects of the great toe that include exposed tendon and bone present a reconstructive challenge for plastic surgeons. This study investigates the feasibility and reliability of reverse first dorsal metatarsal artery flap (FDMA) for reconstruction of the dorsal great toe soft-tissue defects.
  
  
  METHODS
  Six male patients with dorsal great toe defects (mean 2.2 x 4.7 cm) underwent reconstruction using the reverse FDMA flap. Preoperative angiography was performed to confirm the existence and patency of the distal communicating artery between the FDMA and plantar metatarsal artery. The flap was raised by dividing the dorsalis pedis artery and proximal communicating arteries and rotated 180 degrees to cover the defect.
  
  
  RESULTS
  All flaps survived completely. Mean follow-up time was 3.3 months. Painless full range of motion was recovered and the contour of the flap was satisfactory. All patients returned to their normal walking and running activities and none necessitated special footwear. No donor-site morbidity was encountered.
  
  
  CONCLUSIONS
  Reverse FDMA flap presents a viable alternative for reconstruction of soft-tissue defects of dorsal great toe when local flap coverage is required. Because of anatomic variations, preoperative angiography is necessary for successful reconstruction, especially in patients with comorbidities affecting patency of their vasculature.
authors: Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung, Chang Gung University, Taipei, Taiwan. minghueicheng@hotmail.com
authors: Ming-Huei
authors: MH
authors: Cheng
authors: Betul Gozel
authors: BG
authors: Ulusal
authors: Fu-Chan
authors: FC
authors: Wei