The use of the extensor digitorum brevis muscle as a local muscle island flap for the cover of soft tissue defects in the lower extremity is presented. The anatomy of the muscle, the blood supply, the elevation, and use of the extensor digitorum brevis muscle flap in the lower extremity are discussed. This flap offers a mean area of 27 cm 2, which can cover large skin defects otherwise difficult to treat. A case of trauma to the medial Correspondence to." A.D. Mandrekas, MD, Ipsilantou 18, Kolonaki-Athens 10676, Greece malleolus is presented; this was treated successfully with the extensor digitorum brevis muscle flap.