title: Reconstruction of great toe soft-tissue defect with the retrograde-flow medial pedis island flap.
abstract: BACKGROUND
  Several investigators have reported their clinical experience with medial pedis flaps for reconstruction of soft-tissue defects of the distal forefoot. However, they had only a few reports where this flap was used to repair soft-tissue defects of the great toe. Thus, reconstruction of soft-tissue defects of the great toe remains a challenge in reconstructive surgery. The authors describe the use of the medial pedis island flap to cover this region.
  
  
  METHODS
  This study was divided into two parts: an anatomic study and clinical application. In the anatomic study, 48 cadaveric feet were injected with latex, and then the main vessels distributed at the medial aspect of the foot were observed. Clinically, retrograde-flow medial pedis island flaps were harvested to cover the soft-tissue defects of the great toe in eight cases.
  
  
  RESULTS
  An anatomic study revealed that the arterial circle under the first metatarsophalangeal joint and the arterial network on the surface of the abductor hallucis were responsible for the blood supply of the medial region of the foot. The diameter of the pedicle was great, and the pedicle was longer than previously reported. In terms of clinical application, all flaps were successful, without any significant complications.
  
  
  CONCLUSIONS
  Using the arterial circle under the first metatarsophalangeal joint, the medial pedis island flap has a reliable retrograde blood supply. This flap should be considered as a preferential way of reconstructing soft-tissue defects of the great toe.
  
  
  METHODS
  Therapeutic, V.
authors.affiliation: Philadelphia, Pa.; and Ningbo, Zhejiang, People's Republic of China From the Department of Orthopaedic Surgery, Pennsylvania Hospital, University of Pennsylvania School of Medicine; and the Department of Orthopaedic Surgery, Affiliated Hospital, and the Department of Anatomy, Medical School of Ningbo University.
authors.forename: Haijiao
authors.initials: H
authors.lastname: Mao
authors.forename: Zengyuan
authors.initials: Z
authors.lastname: Shi
authors.forename: Weigang
authors.initials: W
authors.lastname: Yin
authors.forename: Wenwei
authors.initials: W
authors.lastname: Dong
authors.forename: Keith L
authors.initials: KL
authors.lastname: Wapner
mesh_terms: D000328:Adult; D002102:Cadaver; D005260:Female; D006214:Hallux / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*