Premium
Free great toe wrap‐around flap combined with second toe medial flap for reconstruction of completely degloved fingers
Author(s) -
Rui Yongjun,
Mi Jingyi,
Shi Haifeng,
Zhang Zhihai,
Yan Hede
Publication year - 2010
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20777
Subject(s) - medicine , second toe , surgery , microsurgery , anatomy
Surgical procedure of great toe wrap‐around flap combined with second toe medial flap free transfer for reconstructing completely degloved fingers was introduced. The treatment outcomes were evaluated. 10 fingers in 7 cases were involved in this series. The great toe wrap‐around flap with dorsalis pedis skin covered the dorsal and most palmar side of the injured finger. The second toe medial flap covered the proximal palmar portion of the finger. The combined flap was revascularized with nerve repair. Rehabilitation started two weeks postoperatively. All flaps survived except one was partial failure due to distal phalange necrosis. Recipient areas achieved primary wound healing in 9 fingers. Skin graft at donor site achieved primary survival except delayed healing in one case. All patients were followed‐up from 34 to 76 months. The appearance of reconstructed fingers was satisfactory. Nail growth well except that one nail was the atrophic and another was defect. Range of active motion in the metacarpophalangeal joint was from 60° to 80° and the proximal interphalange joint was 40° to 70°. Two‐point discrimination was between 8 mm and 12 mm. All patients walked with no interference. There was no pain and no swelling at donor site. According to the results, this procedure is recommended to reconstruct total degolving finger which has intact phalanges and tendons. © 2010 Wiley‐Liss, Inc. Microsurgery 30:449–456, 2010.