Reconstruction of the lower leg and foot with the reverse-pedicled anterior tibial flap: preliminary report of a new fasciocutaneous flap.

The blood supply to the skin of the anterior leg was studied in 10 fresh cadavers. Particular attention was paid to the intermuscular septal blood vessels, which emerge in the cleft between tibialis anterior and extensor hallucis longus and extensor digitorum longus muscles. With this anatomical knowledge, the reverse-pedicled anterior tibial fasciocutaneous flap was designed and transferred clinically to cover lower leg and foot defects in 6 patients. Three case reports are detailed. The factors which allow a distally based flap to be raised in the lower leg against the direction of venous valves are also described. The versatility of this new flap in the reconstruction of defects of the lower leg and foot is discussed.