Foot salvage after loss of the first and second metatarsal rays with a free fibular osteocutaneous flap

Christopher J. Salgado, Chih Hung Lin, David A. Fuller, Alissa N. Duncan, Liliana Camison, Samir Mardini

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Severely comminuted fractures of the metatarsal bones with significant bone and softtissue loss have commonly subjected patients to proximal amputation procedures. We describe two patients who experienced high-energy traumatic injuries to their limbs that resulted in significant destruction of their first and second metatarsal bones with overlying soft-tissue trauma not amenable to local coverage. In both cases, a vascularized free fibular osteocutaneous flap was used to reconstruct the metatarsal bone defect and traumatized soft tissues so that a proximal amputation was avoided. At an average of 14 months of follow-up, both patients had recovered well and regained independent ambulation, with one patient being able to play soccer. We show that the free fibular osteoseptocutaneous flap is useful in reconstructing significant metatarsal bone defects and in avoiding amputations in this patient population. The skin component of the flap may be used to fill soft-tissue losses, and the fibula bone may be osteotomized so that more than one ray may be reconstructed.

Original languageEnglish (US)
Pages (from-to)531-536
Number of pages6
JournalJournal of the American Podiatric Medical Association
Volume101
Issue number6
DOIs
StatePublished - Jan 1 2011

ASJC Scopus subject areas

  • Podiatry
  • Orthopedics and Sports Medicine

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