Free ALT flap resurfacing of soft-tissue defect in foot due to large tophaceous gout: Case report and literature review

Large or extensive gouty tophi on the foot can cause functional impairment, drainage sinus, and infected necrosis, finally resulting in complex soft-tissue defects with tendon, joint, bone, nerve, and vessel exposure. Reconstruction of complex soft-tissue defects of the foot remains a challenge. We report the case of a 50-year-old patient, who suffered from large tophus mass involving the metatarsal joints of left big toe. We reconstructed the large, ulcerative skin and soft-tissue defects on the dorsum of the foot with a free anterolateral thigh (ALT) flap after adequate debridement and achieved good functional results.