Muscle transposition in the management of perforating ulcers of the forefoot.

Perforating ulcers of the foot that fail to respond to conservative medical or surgical treatment are usually treated by ablative surgery. This treatment may include removal of one or more metatarsophalangeal joints, which transfers weight-bearing to an area not designed for this purpose. Ablative surgery often leads to forefoot deformities that require additional surgical treatment. Reconstructive, rather than destructive, surgery is recommended to preserve normal foot function. The plantar surface can be preserved by a muscle transposition procedure followed, if necessary, by the application of a skin graft, which is superior to healing by scar tissue.