PMC6742865_01
(a-b) Preoperative images of the right hallux. (c) Preoperative radiograph of the right hallux. (d) Intraoperative images after removal of the necrotic tissue.
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F1
Carbonization from the center of the proximal phalanx of the hallux and a fracture at the proximal phalanx without dislocation were observed (Fig.1a-c). To remove necrotic tissue, the hallux was amputated at the interphalangeal joint (Fig. 1d), and the soft-tissue defect of the base phalanx was covered with a reverse EDB flap.
(a-d) Intraoperative images of the reverse extensor digitorum brevis flap. (e and f) The surgical site at the right hallux, 12 months after surgery.
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F2
The distal parts of the dorsalis pedis artery and vein were dissected to the pivot point to elevate the flap (Fig. 2a). This was rotated to cover the bony and tendinous surface of the base of the hallux, fixed with bolster sutures (Fig. 2b and c), and a split-thickness thigh skin graft was used to cover it (Fig. 2d). The donor and recipient sites healed completely (Fig. 2e and f).