The flap-bag technique: A new closure technique for treatment of cleft foot deformities with two central ray deficiencies

Abstract

Background: The use of conventional techniques in treating cleft foot deformities with two central ray deficiencies often yields unsatisfactory outcomes. This study describes the flap-bag technique, a novel technique using both a dorsal rectangular flap and a plantar triangular flap that was designed to yield more favorable outcomes in the treatment of this condition, and the outcomes obtained for three patients surgically treated with this technique. Methods: After the proper width of the forefoot was measured by manually holding the toes to maintain a transverse arch around the metatarsophalangeal (MTP) joint, a plantar triangular flap was designed. A dorsally based rectangular flap was subsequently designed on the dorsal side of the interdigital portion, including the deepest side of the cleft, to create a natural dorsal slope. Results: Application of this technique yielded favorable outcomes by maintaining the width and transverse arch of the forefoot, preventing dorsal scarring, and creating a natural interdigital space and dorsal slope. Conclusion: Compared to the use of conventional techniques, use of the flap-bag technique achieves correction of a cleft foot with a more cosmetically desirable outcome. Keywords: Cleft foot deformity, Two central ray deficiencies, Surgical closure technique