Tendocutaneous free flap transfer from the dorsum of the foot

Abstract

Tendocutaneous free flap transfers have been used to treat troublesome wounds involving skin and tendons, with the dorsum of the foot being the most frequent donor site. The free flap consists of the dorsalis pedis artery, saphenous vein, a branch of the superficial peroneal nerve, long extensor tendons and overlying skin. We have performed tendocutaneous free flap from the dorsum of the foot for 13 cases of skin and tendon loss from the dorsum of the hand and wrist. The size of flap was from 6 cm x 5 cm to 11.5 cm x 7.1 cm (average 9.2 cm x 5.9 cm), and the transferred tendons ranged from 1 to 5 in number (average 2.9), and 5 cm to 17 cm in length (average 9.2 cm). Eight of these flaps were reviewed. The transferred flaps survived in all cases and the transferred tendons were functioning well except in two cases of electrical burn. The complications included two cases of tendon adhesion and one case of the marginal necrosis of the flap. Three cases of donor site wound problems were found.