title: Treatment of the Secondary Defect on the First Metatarsophalangeal Joint Using the Medial Plantar Hallucal Artery Dorsal Perforator Flap.
abstract: Injuries or burns to the dorsum of the first metatarsophalangeal (MTP) joint may develop scar formation, resulting in hyperextension contracture. Surgical correction of the deformity often produces a secondary defect. The purpose of this study is to report on the use of the medial plantar hallucal artery dorsal perforator flap for the treatment of such defect. From February 2010 to June 2011, 16 patients were treated. The mean preoperative hyperextension of the first MTP joint was 48 degrees. The mean size of the defects was 3.6 × 6 cm. The mean flap size was 4 × 6.5 cm. The mean pedicle length was 4 cm. All flaps survived completely. Patient follow-up lasted a mean of 14 months. At the final follow-up, the mean hyperextension of the first MTP joint was 9 degrees. After surgery, the mean Foot Function Index improved from 62 to 7. Almost all patients were satisfied with the results. Transferring the medial plantar hallucal artery dorsal perforator flap is a useful and reliable technique for the reconstruction of the secondary defect on the first MTP joint.
authors.affiliation: From the *Hand Surgery Department, The Second Hospital of Qinhuangdao, Qinhuangdao; †Orthopaedics, Beidaihe Hospital, Qinhuangdao; ‡Department of Hand Surgery, The Second Hospital of Tangshan, Tangshan; and §Hand Surgery Department, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.forename: Guangqi
authors.initials: G
authors.lastname: Bai
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Zhang
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.forename: Yadong
authors.initials: Y
authors.lastname: Yu
authors.forename: Xinzhong
authors.initials: X
authors.lastname: Shao
mesh_terms: D000293:Adolescent; D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000098:blood supply / Q000601:surgery; D018409:Foot Injuries / Q000150:complications*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000293:injuries* / Q000601:surgery; D008875:Middle Aged; D017060:Patient Satisfaction; D061525:Perforator Flap / Q000098:blood supply; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult