Case: A motorcycle accident resulted in severe soft tissue loss on the foot's dorsum with irreparable hallucis extensors, with exposure of the first metatarsal and hallux. An arthrodesis of the hallux interphalangeal joint, a transfer of the second toe's extensor digitorum longus, and an anterolateral thigh free flap were performed simultaneously. The patient obtained a fair result and could wear regular shoes.
Discussion: This is the first report describing this orthoplastic reconstructive option in these complex injuries. It replenished both hallux extensor tendons and soft tissue coverage losses without severely compromising the foot's contour, recreating anatomy and function.
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